Innohep (tinzaparin) / LEO Pharma - LARVOL DELTA

Comparative safety of enoxaparin versus other low-molecular-weight heparins in cancer-associated venous thromboembolism: a real-world cohort study from RIETE. (PubMed, Res Pract Thromb Haemost) - "In this large, observational study, enoxaparin, particularly in twice-daily regimens, was associated with significantly increased risks of bleeding and mortality compared to tinzaparin/dalteparin. These findings may help refine LMWH selection and dosing strategies in patients with cancer-associated VTE and warrant further investigation in prospective studies."

Journal • Real-world evidence • Cardiovascular • Oncology • Venous Thromboembolism

Tinzaparin Pharmacokinetics in Patients with Cancer: A Comparative Modeling Study. (PubMed, Thromb Haemost) - "No significant differences were observed between matched cancer and non-cancer patients in anti-Xa activity exposure at day 1 and steady state.PK profiles were comparable between cancer and non-cancer patients. Additionally, further studies should clarify the role of renal function in guiding tinzaparin dosing."

Clinical • Journal • PK/PD data • Cardiovascular • Hematological Disorders • Oncology • Thrombosis

Tinzaparin for the prevention of thromboembolic events in ambulatory patients with metastatic colorectal cancer receiving first line treatment: a randomised, clinical trial design. (PubMed, BMC Cancer) - P3 | "Risk prediction of chemotherapy-associated VTE is a compelling challenge in oncology, as VTE may result in treatment delays, impaired quality of life, and increased mortality. Patients with a single type of metastatic cancer with a high risk of VTE will be selected for study inclusion. For the first time in ambulatory prophylaxis of cancer-associated thrombosis, a precision medicine approach will be used in a clinical trial. If the individualization of antithrombotic prophylaxis can reduce the complications of outpatient cancer treatment and be cost effective, it would be of great value in the future care of patients with metastatic CRC."

Clinical • Clinical protocol • Journal • Cardiovascular • Colorectal Cancer • Hematological Disorders • Oncology • Solid Tumor • Venous Thromboembolism • BRAF

Pulmonary Embolism Following Quadriceps Tendon Repair With Tourniquet Use Despite Adequate Thromboprophylaxis: A Case Report. (PubMed, Cureus) - "We report the case of a 53-year-old man (BMI 42 kg/m²) with morbid obesity who developed acute pulmonary embolism (PE) following quadriceps tendon repair performed with tourniquet assistance, despite receiving extended perioperative thromboprophylaxis with tinzaparin. This case highlights the interplay between tourniquet use, patient-specific risk factors (obesity, delayed surgery, and reduced mobility), and the adequacy of standard-duration prophylaxis. We also discuss why existing arthroplasty data may not directly apply to tendon repair surgery and the need for individualized prophylaxis strategies in high-risk patients."

Journal • Cardiovascular • Genetic Disorders • Obesity • Orthopedics • Pulmonary Embolism • Respiratory Diseases • Venous Thromboembolism

Tinzaparin for the prevention of thromboembolic events in ambulatory patients with metastatic colorectal cancer receiving first line treatment: a randomised, clinical trial design (BMC Cancer) - "PROTINCOL (NCT05625932) is a randomized, open-label (PROBE), multicenter study. Patients will receive tinzaparin (75 IU/kg) or no pharmacological prophylaxis for 4 months and will be stratified based on: BRAF/RAS mutation, primary resection tumor and antiangiogenic therapy. The study outcomes will be assessed by a blinded central independent adjudication committee. The primary efficacy endpoints will include the cumulative incidence of any venous thromboembolism (VTE) event (symptomatic or incidental) including symptomatic central venous catheter VTE. Secondary variables will be clinically relevant bleedings, health-related quality of life and the predictive value of validated risk assessment scales of VTE, including the genetic risk score (TIC-ONCO)."

Trial status • Colorectal Cancer • Venous Thromboembolism

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

Updated Meta-Analysis of Randomized Controlled Trials on Primary Outpatient Thromboprophylaxis (POTP) in Patients with Lung Cancer Receiving Chemotherapy (ASH 2023) - "The prophylactic doses of bemiparin, certoparin, dalteparin, nadroparin, semuloparin and tinzaparin, intermediate dose of enoxaparin and prophylactic dose of rivaroxaban and apixaban were used in the studies. In our subgroup meta-analysis of POTP with DOACs, there was no statistically significant difference in reduction of VTE in LC patients with Khorana Score ≥2. Hence, the selection of appropriate patients who are high risk for VTE is crucial and further studies are required to define high risk subsets of LC patients receiving chemotherapy who may benefit from POTP."

Retrospective data • Cardiovascular • Lung Cancer • Oncology • Solid Tumor • Venous Thromboembolism

Impact of Obesity on Anticoagulation Dosing and Clinical Outcomes in Pediatric Patients with Venous Thrombo-Embolism (ASH 2024) - "Anticoagulants used included LMWHs (enoxaparin [78.4%], dalteparin [n=1.9%], and tinzaparin [n=1.9%]) followed by UFH (17.4%) and were comparable between obese and non-obese children (p=0.797). Conclusion : In children receiving therapeutic anticoagulation for VTE, mostly treated with enoxaparin, obesity was associated with lower anticoagulation requirements. Further prospective work is urgently needed to explore alternate dosing regimens in obese pediatric patients, such as dose capping, reduced initial dosing, or the use of fat-free mass."

Clinical • Clinical data • Cardiovascular • Genetic Disorders • Heart Failure • Obesity • Pediatrics • Venous Thromboembolism

Efficacy and Safety Outcomes in Patients with Cancer-Associated Thromboembolism Treated with Tinzaparin According to the Tumor Site: Meta-Analysis of Prospective Studies Involving 1413 Individual Patients' Data (ASH 2023) - P=N/A, P3 | "Conclusion In CAT patients receiving tinzaparin for up to 6 months, rVTE and MB vary according to tumor site. The CAT entity is not sufficient to describe a situation at risk of recurrence or bleeding for patient management."

Retrospective data • Cardiovascular • Gynecologic Cancers • Hematological Malignancies • Lung Cancer • Oncology • Solid Tumor • Thrombosis

Efficacy and Safety of Extended Duration Postoperative Thromboprophylaxis with Low-Molecular-Weight-Heparin Among Subgroups of Patients Undergoing Surgical Resection of Colorectal Cancer: A Post-Hoc Analysis of the Periop-01 Trial (ASH 2023) - " This is a pre-planned post-hoc analysis of the PERIOP-01 randomized controlled trial which compared extended (up to 6 weeks) to standard duration (in hospital only) of perioperative thromboprophylaxis with tinzaparin (4500 IU SC daily) in patients undergoing surgical resection of localized colorectal cancer... In the PERIOP-01 trial, extended thromboprophylaxis didn't reduce the risk of major VTE in any subgroups of patients. On the other hand, extended duration of thromboprophylaxis may be associated with an increased bleeding risk among male, elderly patients, and those with colon cancer."

Clinical • Retrospective data • Colon Cancer • Colorectal Cancer • Gastrointestinal Cancer • Oncology • Solid Tumor

Heparin-Induced Thrombocytopenia Following Tinzaparin Administration: A Case Report. (PubMed, Cureus) - "Initial investigations revealed isolated thrombocytopenia, and a high clinical suspicion based on a 4Ts score of 6 prompted the immediate discontinuation of tinzaparin and initiation of fondaparinux...The patient's platelet counts improved in a few days, and he was successfully transitioned to warfarin without complications. This case highlights the critical importance of maintaining a high index of suspicion for HIT in any patient exposed to Heparin products, including LMWH, who develops thrombocytopenia, even when the clinical presentation is atypical. Early recognition and prompt management with alternative anticoagulants are essential to prevent life-threatening thromboembolic complications."

Journal • Cardiovascular • Hematological Disorders • Thrombocytopenia

The Crucial Role of Tinzaparin in Managing Venous Thromboembolism in the Cancer Population. (PubMed, J Clin Med) - "In the CATCH study, tinzaparin showed a significant reduction in clinically relevant non-major bleeding compared to warfarin. While direct oral anticoagulants (DOACs) offer convenience, LMWHs like tinzaparin remain crucial, especially for patients with specific characteristics such as renal insufficiency, complex drug interactions, or a high risk of gastrointestinal bleeding. Tinzaparin's favorable safety and efficacy, along with its unique pharmacological properties, make it a valuable option for managing VTE in the complex oncology population."

Journal • Review • Cardiovascular • Gastroenterology • Hematological Disorders • Nephrology • Oncology • Renal Disease • Venous Thromboembolism

An Unusual Case of Tinzaparin-Induced Haemorrhagic Bullous Dermatosis: Diagnostic and Therapeutic Challenges. (PubMed, Eur J Case Rep Intern Med) - "Delayed onset (8-10 days post-initiation of low molecular weight heparin), dose independent.Haemorrhagic bullous dermatosis is not a hypersensitivity reaction.High-risk profile: age >70 years-old, estimated glomerular filtration rate <30 ml/min, concomitant steroids, or vascular fragility."

Journal • Bullous Pemphigoid • Cardiovascular • Dermatology • Dermatopathology • Hematological Disorders • Hypertension • Immunology • Pulmonary Embolism • Respiratory Diseases • Thrombocytopenia • Vasculitis

Intracranial Hemorrhage With Direct Oral Anticoagulants vs Low-Molecular-Weight Heparin in Brain Tumors: A Review and Meta-Analysis. (PubMed, Neurology) - "In the current meta-analysis, DOACs were associated with significantly lower ICH risk than LMWH in patients with anticoagulated brain tumor, particularly those with primary brain tumors. Findings support DOACs as a safe anticoagulant in arterial and venous thromboembolism. Given observational designs with inherent confounding, findings warrant cautious interpretation."

Journal • Retrospective data • Brain Cancer • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Oncology • Solid Tumor • Venous Thromboembolism

Venous Thromboembolism Risk Assessment and Prophylaxis: An Audit-Based Study. (PubMed, Cureus) - "This study underscores the transformative impact of enforced protocol adherence and targeted multidisciplinary staff education on VTE prevention. The integration of an electronic health record system with real-time prompts could further ensure prophylaxis within the critical 24-hour window."

Journal • Cardiovascular • Diabetes • Hematological Disorders • Hypertension • Immunology • Metabolic Disorders • Oncology • Pediatrics • Respiratory Diseases • Venous Thromboembolism

PROTINCOL: TINzaparin Prophylaxis in Patients With Metastatic Colorectal Cancer (clinicaltrials.gov) - P3 | N=232 | Completed | Sponsor: Galician Research Group on Digestive Tumors | Recruiting ➔ Completed | N=526 ➔ 232 | Trial completion date: Mar 2025 ➔ Jun 2025 | Trial primary completion date: Dec 2024 ➔ Jun 2025

Enrollment change • Trial completion • Trial completion date • Trial primary completion date • Cardiovascular • Colon Cancer • Colorectal Cancer • Oncology • Rectal Adenocarcinoma • Solid Tumor • BRAF

Anti-PF4/ Heparin Antibodies Early Seroconversion in Hip Fracture Patients Receiving Low Molecular Weight Heparin Prophylaxis: a Pilot Study of 100 Consecutive Patients. (PubMed, Arch Bone Jt Surg) - "Twenty-seven patients received bemiparin, 42 enoxaparin and 25 tinzaparin. These findings highlight the overall safety of LMWHs in elderly hip fracture patients. Moreover, the presence of anti-PF4/H appears unrelated to PLT fluctuations, subsequent VTE events and early postoperative mortality."

Journal • Hematological Disorders • Musculoskeletal Diseases • Orthopedics • Thrombocytopenia

Thromboprophylaxis in oncology patients with active cancer: results from GMaT and ACT4CAT clinical studies (MASCC-ISOO 2025) - "Anticoagulation agents were (%): 91.2 tinzaparin, 4.6 fondaparinux, 2.3 bemiparin, 1.2 enoxaparin, 0.8 rivaroxaban or apixaban, for 5.1±3.3 months duration. Selection of anticoagulation dose was based on demographics, cancer characteristics, treatment type and patient medical history. InterD was found to be more efficacious and without safety concerns."

Clinical • Metabolic Disorders • Oncology • Thrombosis

PHENOTYPING THE INTRINSIC THROMBIN GENERATION IN PLASMA SAMPLES CONTAINING HEPARIN: THE CASE OF TINZAPARIN NEUTRALIZATION. (EHA 2025) - "Our results highlight the difficulty of recovering the underlying coagulability of plasma samples prepared from tinzaparin-treated patients. Heparinase is effective in neutralizing tinzaparin in spiked plasma but cannot fully restore TG in plasma from treated patients. This is likely to be due to TFPI release upon heparin administration."

Clinical • Hematological Malignancies • Multiple Myeloma • Oncology

Comparing trauma-induced coagulopathy in hip fracture surgery and elective hip arthroplasty: a thrombelastography study (ISTH 2025) - "Serial whole blood samples were collected preoperatively and postoperatively up to 12 weeks and analyzed using TEG.Thromboprophylaxis was standardized to aspirin 81mg for 28 days following THA, and given at the surgeon’s discretion for HFS, with most patients receiving tinzaparin 4500 units for 35 days. Complications of VTE occurred in 2 (5.3%) THA patients and 11 (5.3%) HFS patients, mostly occurring in the early postoperative period. Table or Figure Upload"

Surgery • Cardiovascular • Musculoskeletal Diseases • Oncology • Orthopedics • Venous Thromboembolism

Apixaban and tinzaparin reverse anticancer drug resistance caused by fibrin clot shields in tumors (ISTH 2025) - "In 2h after FCS formation, paclitaxel (PTX) or 4-hydroxytamoxifen (4OHTam) at IC50 were added and cell viability was assessed after 72 hours. Data are shown in Figure 1. Table or Figure Upload"

Breast Cancer • Hormone Receptor Breast Cancer • Oncology • Pancreatic Cancer • Solid Tumor • Triple Negative Breast Cancer • ER

A pediatric case of a possible oral anticoagulant related nephropathy. (ISTH 2025) - "After transitioning from enoxaparin to rivaroxaban, the patient developed gross hematuria, and his creatinine spiked from 59 to 114 µmol/L within 12 hours of the first rivaroxaban dose (Graph 1). Therapy was switched back to enoxaparin and subsequently, to tinzaparin due to drug accumulation...The patient was transitioned to apixaban, which provided more stable renal function, though mild creatinine elevations (range: 80–112 µmol/L) persisted...Ultimately, CVT resolved and anticoagulation was discontinued. Table or Figure Upload"

Clinical • Cardiovascular • Hematological Disorders • Nephrology • Pediatrics • Rare Diseases • Renal Disease • Thrombosis • Vasculitis

Long-term outcomes beyond 6-months for cancer-associated thrombosis in the era of DOACs (ISTH 2025) - "In half of all patients (6/12), tinzaparin was the anticoagulant prescribed, with apixaban and rivaroxaban prescribed in 2 patients each, warfarin in 1 patient, and 1 undocumented. 1 patient died of PE after the initial thrombotic event. Otherwise, there were no CRB or VTE complications."

Oncology • Prostate Cancer • Solid Tumor • Thrombosis • Venous Thromboembolism

Heparin use on hemodialysis – influencing factors (ERA 2025) - "Since the literature indicates a lower dose for low-molecular-weight heparins in dialysis, the comparison of the heparin usage was made on the basis of standardized international units (for both LMWH in use, enoxaparin and tinzaparin, a higher efficacy by a factor of 1.4 was assumed). In our study, hemodiafiltration and the new CorAL dialyzer led to a statistically significant decrease in the use of heparin, but the effect is clinically negligible. There are other treatment and patient-specific parameters like male gender, high body weight and young age as well as a long dialysis time that have a greater influence on the heparin dose than the modality or the dialyzer."

Diabetes • Metabolic Disorders

Reducing unnecessary carbon in haemodialysis by reducing pharmaceutical waste in a dialysis unit (UKKW 2025) - "In April 2024, the nursing staff reviewed all medications that were discarded due to being over their expiry date. This included ten glucose 50% solution for infusion 50ml vials, 20 boxes containing ten vials each of Tinzaparin 7500 IU/0.3mls ampoules, four hydrocortisone 100mg powder for solution for injection vials, a box of carbocisteine 375mg capsules (120 capsules), ten ferric carboxymaltose 100mg/2ml solution for injection vials, a bottle of Gaviscon liquid and a box containing 10 ampoules of ondansetron 4mg/2ml solution for injection (Figure 1). The total financial impact of these discarded medications alone was measured at approximately £1,260 and 732 kgCO2e (Table 1)."