Entwicklung und Perspektiven der niedermolekularen Heparine

Zusammenfassung

Niedermolekulares Heparin (LMWH) hat nach intravenöser und subkutaner Injektion längere Halbwertszeiten im Plasma und wird wesentlich vollständiger resorbiert, als unfraktioniertes Standardheparin (UFH). Zahlreiche Untersuchungen haben gezeigt, daß LMWH sich gut zur subkutanen Applikation bei der Behand-lung der tiefen Beinvenenthrombose eignet, auch wenn es nur einmal am Tag und mit fester Dosis gegeben wird. Bei subkutaner Gabe von LMWH wird ein etwas günstigerer Thromboseverlauf und werden etwas weniger Blutungen beobachtet als nach UFH. LMWH ist aber deutlich teurer. Der wesentliche Vorteil von LMWH liegt jedoch darin, daß man etwa 75% der Thombosepatienten ambulant behandeln kann, was zu einer Kostenreduktion von etwa 50% führt, weil eine Einsparung der Krankenhauskosten am stärksten ins Gewicht fällt. Damit ist eine stationäre Behandlung von Thrombosepatienten in vielen Fällen unnötig geworden.

Summary

Low molecular weight heparin (LMWH) has a longer half life after intravenous or subcutaneous injection in humans than unfractionated heparin (UFH) and is after subcutaneous injection much more completely absorbed. It has been shown in numerous studies that LMWH can be used for subcutaneous treatment of deep venous thrombosis, even with only one injection daily and without monitoring. After subcutaneous application of LMWH, regression of thromboses is more often seen than after UFH, bleedings are not seen that often. LMWH is however much more expensive than UFH. The most important advantage of LMWH is that it allows ambulatory treatment of patients in about 75% of the cases. This leads to a reduction of the treatment costs of about 50%, as hospital costs are most important in patient treatment. That makes a hospital treatment in many cases unnecessary.

Schlüsselwörter

Tiefe Beinvenenthrombose - niedermolekulares Heparin - unfraktioniertes Heparin - ambulante Therapie

Keywords

Deep vein thrombosis - low molecular weight heparin - unfractionated heparin - outpatient treatment

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