Is now a reality

Papers p 1212

Heparin therapy for at least five days followed by long term oral anticoagulation has been the standard care for patients with acute deep vein thrombosis.1 Initiation of treatment usually requires patients to be admitted to hospital for administration of intravenous unfractionated heparin and dose adjustment according to the results of the activated partial thromboplastin time. However, the emergence of low molecular weight heparin as a safe, effective, and convenient treatment for deep vein thrombosis has challenged the need for routine admission. A paper in this week's issue adds to the evidence that home treatment of deep vein thrombosis is now routinely feasible (p 1212).2

Aggregate data from a recent meta-analysis of randomised trials,3 also summarised in a Cochrane systematic review,4 show that low molecular weight heparin is at least as effective and safe as unfractionated heparin for the initial treatment of deep vein thrombosis. Unlike unfractionated heparin, which is usually given by continuous intravenous infusion, low molecular weight heparin can be given subcutaneously in a fixed, weight adjusted dose without the need for laboratory …