fondaparinux / Generic mfg. - LARVOL DELTA

When pregnancy, HIT, and stroke collide: Navigating complex thrombotic care in a community-based setting (ASH 2025) - "Case Presentation: A 30-year-old woman, gravida 1 para 0, with a history of unprovoked lower extremity deep vein thrombosis (DVT) on chronic rivaroxaban for secondary prophylaxis was transitioned to low-molecular-weight heparin (enoxaparin) upon confirmation of pregnancy at 7 weeks' gestation...Enoxaparin was discontinued, and argatroban was initiated post-EVT, later transitioning to subcutaneous danaparoid, and ultimately fondaparinux for the remainder of her pregnancy...Another important feature of this case is that it was successfully managed entirely within a regional community hospital system, allowing the patient to stay close to her family and access local rehabilitation services. This case report highlights the ability of community-based hospitals to provide high-acuity, patient-centered care through strong interdisciplinary collaboration."

Cardiovascular • Hematological Disorders • Infectious Disease • Novel Coronavirus Disease • Thrombocytopenia • Thrombosis

Platelet dynamics and clinical outcomes in patients with heparin-induced thrombocytopenia – single center experience (ASH 2025) - "Several agents, such as bivalirudin, argatroban, danaparoid, and fondaparinux, have been used for the treatment of HIT. The dynamics of platelet counts after diagnosis may be an important tool for assessing treatment efficacy. Despite treatment, the mortality rate in critically ill patients with HIT remains high."

Clinical • Clinical data • Cardiovascular • Hematological Disorders • Thrombocytopenia

Heparin-induced thrombocytopenia after percutaneous coronary intervention complicated by hemothorax and pulmonary thromboembolism: The scylla and charybdis of hematology (ASH 2025) - "Those with a confirmed diagnosis need to be started on therapeutic-dose anticoagulation with argatroban, danaparoid, bivalirudin, or fondaparinux. Our case highlights a unique case of HIT with both thrombosis and life-threatening bleeding post-PCI that precluded the use of both anticoagulation and antiplatelets, underscoring the complexity of care, need for a multidisciplinary approach, and individualization of treatment in such cases."

Cardiovascular • Cerebral Hemorrhage • Chronic Kidney Disease • Diabetes • Endocrine Disorders • Hematological Disorders • Hypertension • Metabolic Disorders • Nephrology • Pulmonary Embolism • Renal Disease • Respiratory Diseases • Thrombocytopenia

HIT or miss?: Long-term outcomes of direct thrombin inhibitors vs fondaparinux use in heparin-induced thrombocytopenia (ASH 2025) - "Cohort A had 1489patients diagnosed with HIT and treated with fondaparinux while Cohort B had 1489 patients diagnosedwith HIT and treated with direct thrombin inhibitors (argatroban, bivalirudin, lepirudin or desirudin). Our study provides evidence that fondaparinux significantly reduces the risk of mortality and adverseevents including myocardial infarction, skin necrosis, arterial embolism/thrombosis and moderate tosevere thrombocytopenia at one year compared to DTIs for the management of HIT. In addition to theseclinical benefits, fondaparinux offers cost advantages and ease of use, with its subcutaneousadministration, predictable pharmacokinetics, and minimal need for laboratory monitoring making itparticularly useful in outpatient and resource-limited settings. However, fondaparinux carries anincreased risk of major bleeding, particularly intracranial hemorrhage, due to the lack of a reversal agent.It is also contraindicated in patients with renal impairment and..."

Acute Kidney Injury • Cerebral Hemorrhage • Chronic Kidney Disease • CNS Disorders • Congestive Heart Failure • Diabetes • Diabetic Nephropathy • Fibrosis • Gastroenterology • Genetic Disorders • Heart Failure • Hematological Disorders • Hepatology • Immunology • Ischemic stroke • Liver Cirrhosis • Metabolic Disorders • Myocardial Infarction • Nephrology • Obesity • Pulmonary Embolism • Renal Disease • Respiratory Diseases • Thrombocytopenia

Cost effectiveness of in-house HIT screening testing in community based hospital (ASH 2025) - "Empiric anticoagulation was initiated in 147 (28.8%) patients, withargatroban in 85 (57.8%), fondaparinux in 50 (34.0%), and 12 (8.2%) receiving other anticoagulants(apixaban, rivaroxaban, or bivalirudin)...Only 48 (18.6%) patients received empiricanticoagulation, with argatroban used in 25 (52.1%), fondaparinux in 17 (35.4%), and otheranticoagulants (apixaban and bivalirudin) in 6 (12.5%)...Theimplementation of in-house HIT screening tests resulted in an annual cost saving of $17,181 inanticoagulation alone. ConclusionImplementation of the HIT testing algorithm using an in-house screening test with a reflex outsourcedconfirmatory test resulted in decreased turnaround time, reduction of empiric anticoagulation utilization,and potential cost savings for hospitalized patients with suspected HIT."

Clinical • Cost effectiveness • HEOR • Hematological Disorders • Thrombocytopenia

Association between the Use of Fondaparinux Plus Radial Access and Clinical Outcomes in Patients with Non-ST Elevation Acute Coronary Syndrome. (PubMed, Arq Bras Cardiol) - "The combination of fondaparinux and radial access was associated with the lowest rates of MACE and major bleeding, compared to either strategy alone."

Clinical data • Journal • Acute Coronary Syndrome • Cardiovascular • Myocardial Infarction

Radial Access and Fondaparinux: A Synergistic Interaction. (PubMed, Arq Bras Cardiol) - No abstract available

Journal

Graduated Compression Stockings for Thromboprophylaxis in Orthopaedic and Trauma Surgery: A Rapid Review and Meta-Analysis. (PubMed, J Clin Med) - "Seven studies (N = 5117) compared various combinations of pharmacological prophylaxis, with or without gCS, for a summary RR of 1.44 (95% CI: 0.76-2.72). The results of this rapid review neither show a clear benefit nor support the general use of gCS to prevent TE in orthopaedic and trauma surgery, especially if pharmacological prophylactic measures are established and suitable."

Journal • Retrospective data • Review • Cardiovascular • Hematological Disorders • Musculoskeletal Diseases • Orthopedics • Pulmonary Embolism • Respiratory Diseases

Preferences Among Expert Physicians in Areas of Uncertainty in Venous Thromboembolism Management: Results from a Multiple-Choice Questionnaire. (PubMed, J Clin Med) - "Respondents considered the following to be appropriate: risk assessment of VTE (93.44%) and bleeding (91.6%) in hospitalized medical patients; low-molecular weight heparin (LMWH) prophylaxis for inpatients with pneumonia and malignancy (82.78%); therapeutic doses of LMWH/fondaparinux in patients with intermediate/high risk of PE with (80.9%) or without (77.97%) instability criteria; and echocardiography to manage patients with a post-PE syndrome (93.99%). Respondents considered the following to be inappropriate: use of 4000 IU LMWH in chronic renal failure (80.46%); use of 2000 IU LMWH in persons on dual antiplatelet therapy (77.01%); and use of low-dose apixaban (2.5 mg) in pregnancy (88.57%) or in subsegmental PE with hypoxemia (82.46%)... Our findings show persistent gaps between guideline recommendations and clinical implementation despite improved awareness among physicians. Uncertainty persists regarding criteria for outpatient PE eligibility and/or for validation..."

Journal • Cardiovascular • Chronic Kidney Disease • Hematological Disorders • Infectious Disease • Oncology • Pneumonia • Pulmonary Embolism • Renal Disease • Respiratory Diseases • Venous Thromboembolism

Comparative Effectiveness and Safety of Various Anticoagulation Regimens for Portal Venous Thrombosis in Cirrhosis: A Systematic Review and Network Meta-Analysis. (PubMed, Clin Appl Thromb Hemost) - "DOACs significantly decreased mortality (RR = 0.74; 95% CI: [0.67, 0.81]; p < 0.0001), with LMWH ranked highest (P-score = 0.80) for mortality.ConclusionDOACs, LMWH, and LMWH-Warfarin sequential therapy significantly improved recanalization and reduced PVT progression. LMWH was ranked highest in reducing bleeding and mortality, while fondaparinux ranked highest regarding esophageal bleeding and complete recanalization."

Clinical • HEOR • Journal • Retrospective data • Review • Cardiovascular • Fibrosis • Gastroenterology • Hematological Disorders • Hepatology • Immunology • Liver Cirrhosis • Thrombosis

Efficacy and safety of tranexamic acid combined with low molecular weight heparin versus fondaparinux sodium following total knee arthroplasty: a retrospective cohort study. (PubMed, Front Pharmacol) - "Both regimens showed comparable efficacy in managing perioperative blood loss, operative time, hospital stay, and transfusion requirements in TKA patients. Given the retrospective design and limited sample size, further validation through high-quality, large-scale prospective studies is warranted."

Journal • Retrospective data • Acute Kidney Injury • Cardiovascular • CNS Disorders • Epilepsy • Hematological Disorders • Immunology • Infectious Disease • Orthopedics • Osteoarthritis • Pain • Pulmonary Embolism • Renal Disease • Respiratory Diseases • Rheumatology • Thrombosis

Influence of heparin-based anticoagulants on antibiotic therapy. (PubMed, Front Immunol) - "Given the prevalence of negatively charged anticoagulants in clinical settings, we aimed to explore the effects of unfractionated heparin, low molecular weight heparin, and fondaparinux on the antibacterial activity of AMCs and antibiotics (colistin, daptomycin, gentamicin, imipenem, ofloxacin, and vancomycin). These findings support our hypothesis that specific heparin-based anticoagulants interfere with the activity of blood-derived AMCs and positively charged antibiotics, reducing their efficacy in vitro. Our research aims to provide a foundation for future studies focused on optimizing anticoagulant use in clinical settings, ultimately improving patient outcomes in the ongoing fight against multidrug-resistant bacteria."

Journal • Infectious Disease

Alternative Anticoagulation for Patients with Heparin-Induced Thrombocytopenia on ECMO: A Narrative Review. (PubMed, Biomedicines) - "Most available data, primarily from retrospective studies, describe the use of argatroban in ECMO patients with HIT. Bivalirudin has also been used as an alternative anticoagulant in this population, with no significant increase in bleeding or thrombotic complications...Fondaparinux has shown effectiveness in the HIT setting and appears to have a low risk of complications. Factor XIIa inhibitors represent a novel class of anticoagulants currently under investigation, evaluated only in animal models. Growing clinical experience with alternative anticoagulants, particularly direct thrombin inhibitors, suggests that their use will likely become a primary focus in ECMO anticoagulation management in the coming years."

Journal • Review • Cardiovascular • Critical care • Hematological Disorders • Thrombocytopenia • Thrombosis

HIPSTER-Pilot: Hip Fracture Surgery Arterial and Venous Thrombotic Events Prevention (clinicaltrials.gov) - P3 | N=100 | Not yet recruiting | Sponsor: McMaster University

New P3 trial • Cardiovascular • Musculoskeletal Diseases • Orthopedics • Venous Thromboembolism

Risk Factors Associated with Anticoagulant-Related Bleeding in Patients with Cancer-Associated Thrombosis (ASH 2023) - "Most patients received anticoagulant therapy with LMWH (47.7%), followed by DOACs (26.8%), VKAs (24.5%), and fondaparinux (1%)... In this study, many candidate variables in available risk prediction models for anticoagulant-related bleeding were not associated with bleeding risk. This may explain the performance of these models in patients with cancer on anticoagulant therapy. We identified cancer-specific candidate variables that were associated with risk of anticoagulant-related bleeding."

Clinical • Addiction (Opioid and Alcohol) • Anemia • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Gastrointestinal Cancer • Genito-urinary Cancer • Hematological Disorders • Hepatology • Hypertension • Ischemic stroke • Oncology • Thrombosis • Venous Thromboembolism

Nationwide Analysis of Anticoagulation Therapy Expenditure and Utilization during COVID-19 Pandemic (ASH 2024) - "Other DOACs, such as Rivaroxaban, reflected a decrease in average Medicare spending per beneficiary by 3%, with an 11% increase in total beneficiaries...Average spending per claim with Edoxaban was $617 in 2022, compared to 802$ with apixaban.In contrast to DOACs, total Medicare spending on warfarin decreased by 39%, and Medicaid spending by 33% with total beneficiaries decreasing by 22%...Total Medicare beneficiaries for Dalteparin in 2022 were 111 compared to 298,965 for enoxaparin. Total spending on Dabigatran and Fondaparinux decreased markedly, with a decrease in both the total number of beneficiaries and average spending/claim.Discussion : DOACs continue to be a substantial financial burden for both patients and the healthcare system in terms of prescription cost. However, our study did not consider the logistic parameters such as co-pay for patient's PT/INR testing, working hours lost to commute to the coumadin clinic saved by using DOACs. DOACs are more..."

Infectious Disease • Novel Coronavirus Disease

First in-Human Study with Okl-1111, a Novel Small Molecule Universal Anticoagulant and Platelet Inhibitor Reversal Agent (ASH 2024) - "OKL-1111 reversed the action of a wide variety of anticoagulants (dabigatran, apixaban, rivaroxaban, edoxaban, warfarin, enoxaparin and fondaparinux) as well as platelet inhibitors (ticagrelor and clopidogrel) in vivo without any sign of thrombotic overshoot. OKL-1111 at a single dose of 1000mg reduced the dabigatran-induced lagtime increase in TGA. Discussion : OKL-1111, to our knowledge the first fully universal reversal agent and the only clopidogrel reversal agent, can be safely administered to volunteers up to 1000mg, without (serious) adverse events."

First-in-human • P1 data • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Thrombosis

Comparing Extended Vs. Standard Postoperative Thromboprophylaxis in Patients Undergoing Abdominopelvic Surgery for Malignancy; A Population-Based Cohort Study (ASH 2024) - "Patients with a prescription for vitamin K antagonists (i.e., patients undergoing a heparin to warfarin bridge for long-term anticoagulation) were excluded...Overall, the most common anticoagulant used was enoxaparin (83.4%) followed by rivaroxaban (11.6%), apixaban (4.3%) and fondaparinux (0.6%)...CONCLUSION : In this real-world data set postoperative extended thromboprophylaxis after major abdominopelvic cancer surgery was associated with numerically lower postoperative VTE and 30-day readmission rates, but the absolute benefit may be marginal. Although current practice guidelines suggest pharmacologic thromboprophylaxis for up to 28 days in this high-risk subpopulation, our findings support individualized decision making given the benefit may be relatively low and needs to be balanced with postoperative bleeding risk."

Clinical • Surgery • Cardiovascular • Gastric Cancer • Genito-urinary Cancer • Oncology • Ovarian Cancer • Pancreatic Cancer • Respiratory Diseases • Solid Tumor • Venous Thromboembolism

Comparative Analysis of Perioperative Anticoagulation Management Guidelines across U.S. Institutions (ASH 2024) - "Results Guidelines from 11 academic institutions in different states were reviewed for the perioperative management of warfarin, unfractionated heparin (UFH), low molecular weight heparin (LMWH), direct oral anticoagulants (DOACs), and fondaparinux...82% (9/11) of institutions adjust recommendations based on renal function for all DOACs, while 18% (2/11) only adjust for patients taking dabigatran...For standard bleeding risk procedures with normal renal function, 73% (8/11) institutions hold rivaroxaban or apixaban for 24 hours/1 day prior to the procedure and 27% (3/11) institutions recommend not to take for 2 days...Conclusion Despite international guidelines for perioperative management of anticoagulation, institutions vary in management and language used in guidelines. Efforts are needed to understand if this variability impacts patient outcomes and to find ways to improve guideline implementation."

Clinical • Cardiovascular • Hematological Disorders • Nephrology • Orthopedics • Renal Disease • Venous Thromboembolism

Elimination of Modifiable Risk Factors for Anticoagulant-Related Bleeding in Patients with Cancer Reduces the Probability of Bleeding (ASH 2024) - "Most patients received anticoagulant therapy with low molecular weight heparin (47.7%), followed by direct oral anticoagulants (26.8%), vitamin K antagonists (24.5%), and fondaparinux (1%)...Elimination of all 4 modifiable risk factors (alcohol abuse, anemia, antiplatelet prescription, and uncontrolled HTN) resulted in a 23% reduction in probability of bleeding at 1-year after the start of anticoagulant therapy (6.6% versus 8.5%). Conclusion(s) : Our study found that addressing modifiable risk factors for anticoagulant-related bleeding in patients with cancer has potential to reduce bleeding and thus facilitate continuation of anticoagulant therapy in this high-risk patient population."

Clinical • Anemia • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Gastrointestinal Disorder • Hematological Disorders • Hypertension • Oncology • Venous Thromboembolism

First in-Human Study with Okl-1111, a Novel Small Molecule Universal Anticoagulant and Platelet Inhibitor Reversal Agent (ASH 2024) - "OKL-1111 reversed the action of a wide variety of anticoagulants (dabigatran, apixaban, rivaroxaban, edoxaban, warfarin, enoxaparin and fondaparinux) as well as platelet inhibitors (ticagrelor and clopidogrel) in vivo without any sign of thrombotic overshoot. OKL-1111 at a single dose of 1000mg reduced the dabigatran-induced lagtime increase in TGA. Discussion : OKL-1111, to our knowledge the first fully universal reversal agent and the only clopidogrel reversal agent, can be safely administered to volunteers up to 1000mg, without (serious) adverse events."

First-in-human • P1 data • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Thrombosis

Pain and Health Related Quality of Life in Patients with Superficial Vein Thrombosis: A Post Hoc Analysis of the Multicentre INSIGHTS-SVT Study. (PubMed, Eur J Vasc Endovasc Surg) - "SVT causes moderate early pain and impaired QoL. Although symptoms improve, some patients, especially women and obese individuals, report prolonged discomfort. Routine assessment of patient reported outcomes may improve risk stratification and support individualised, symptom oriented SVT management."

HEOR • Journal • Retrospective data • Cardiovascular • Genetic Disorders • Hematological Disorders • Obesity • Pain • Thrombosis

Bleeding and thrombotic events in patients with heparin-induced thrombocytopenia: a two-decade single-center experience in Thailand. (PubMed, Thromb J) - No abstract available

Journal • Cardiovascular • Hematological Disorders • Thrombocytopenia • Thrombosis

A Rare Case of Portal Biliopathy in the Setting of Cavernomatous Transformation From Chronic Portal Vein Thrombosis (ACG 2025) - "Her hospital course was complicated by Acute Hypoxic Respiratory Failure requiring mechanical ventilation, PEA arrest followed by Return of Spontaneous Circulation, ventilator-associated pneumonia, melena requiring blood transfusions with EGD notable for gastropathy, and heparin-induced thrombocytopenia necessitating a transition from a heparin to fondaparinux...This case highlights the diagnostic and therapeutic complexities of portal biliopathy in the setting of chronic EHPVO, and supports a multidisciplinary approach, including interventional radiology and gastroenterology, when managing such patients.Figure: Figure 1.(A) Fluoroscopic image demonstrating deployment of stent during transjugular intrahepatic portosystemic shunt (TIPS) placement.(B) Contrast-enhanced imaging showing successful shunt creation with opacification of the portal venous system, including recanalization of the thrombosed portal vein and decompression of cavernous collaterals. The irregular..."

Clinical • Cardiovascular • Cholestasis • Hematological Disorders • Hepatology • Infectious Disease • Pneumonia • Respiratory Diseases • Thrombocytopenia • Thrombosis

A Challenging Case of Budd-Chiari Syndrome in a Young Woman With Multiple Thrombophilic Mutations (ACG 2025) - "Anticoagulation was managed with warfarin bridged by fondaparinux. Inhomogeneous liver parenchyma. Ascites present"

Clinical • Back Pain • Cardiovascular • Fibrosis • Heart Failure • Hematological Disorders • Hepatology • Hypotension • Immunology • Musculoskeletal Pain • Pulmonary Disease • Pulmonary Embolism • Rare Diseases • Thrombocytopenia • Thrombosis • PROS1