WEIGHT-BASED DOSING OF ENOXAPARIN AND ANTIFACTOR XA LEVELS FOR VENOUS THROMBOEMBOLISM PROPHYLAXIS IN MEDICALLY-ILL PATIENTS
Keywords:Antifactor Xa, Anticoagulation, Enoxaparin, Low-weight, Thromboprophylaxis, Venous thromboembolism
Objective: The objective of the study was to evaluate peak antifactor Xa (aFXa) levels in low-weight patients receiving enoxaparin for VTE prophylaxis.
Methods: Retrospective cohort of adult patients weighing <55 kg who was hospitalized at tertiary care Center between January 2019 through February 2020. All patients received enoxaparin for VTE prophylaxis with a peak aFXa level drawn. The primary end point was the proportion of patients achieving peak aFXa levels within the goal range of 0.2–0.5 units/ml.
Results: Of 65 patients receiving enoxaparin for VTE prophylaxis with an appropriately timed peak aFXa level, 74% achieved goal peak aFXa levels and the median daily dose of enoxaparin was 30 mg. The mean weight was about 44 kg. No significant correlations between aFXa level and body mass index or body weight were found.
Conclusion: A lower dose of enoxaparin may be reasonable in low-weight patients for VTE prophylaxis. There appears to be no safety concerns with reduced enoxaparin dosing in low-weight patients. More robust data are needed to confirm these findings.
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