Innohep (tinzaparin) / LEO Pharma - LARVOL DELTA

Successful preemptive living-donor kidney transplantation in a young female with end-stage kidney disease from chronic glomerulonephritis complicated by secondary antiphospholipid antibody syndrome: a case report (TTS 2026) - "Course: Perioperative management included 3 sessions of therapeutic plasma exchange (TPE), induction with anti-thymocyte globulin (ATG) and high-dose methylprednisolone, and maintenance tacrolimus, mycophenolate mofetil, and prednisone; anticoagulation with tinzaparin was employed pre- and peri-transplant with multidisciplinary coordination. With careful multidisciplinary planning including TPE, individualized anticoagulation, and adjusted immunosuppression, successful preemptive living-donor renal transplantation with prompt graft function is achievable in patients with APAS and concomitant lupus serology."

Case report • Clinical • Cardiovascular • Chronic Kidney Disease • Glomerulonephritis • Hematological Disorders • Immunology • Inflammatory Arthritis • Lupus Nephritis • Nephrology • Renal Disease • Systemic Lupus Erythematosus • Thrombosis • Transplantation

Intermediate-Dose Tinzaparin Versus Low-Dose Enoxaparin as Thromboprophylaxis in Hospitalized Internal Medicine Patients. (PubMed, Med Sci (Basel)) - "The use of thromboprophylaxis for two weeks post-discharge did not result in any bleeding or clinically evident thrombotic events in either group. In our cohort, the use of intermediate-dose tinzaparin was similar to the use of low-dose enoxaparin for patients with a high PADUA score in terms of thrombotic and/or bleeding events."

Clinical • Journal • Cardiovascular • Hematological Disorders • Thrombosis

Functional roles of tissue factor and EMMPRIN/CD147 present on bladder urothelial carcinoma-derived extracellular vesicles. (ASCO 2023) - "We previously found that the antithrombotic drug Tinzaparin, at clinical concentrations, induces the sufficient release of the tissue factor pathway inhibitor TFPI to functionally inhibit the prothrombotic effector tissue factor expressed on the vesicles released by malignant tumor cells... The tissue factor activity index of urine extracellular vesicles may be considered a marker of bladder urothelial carcinoma. In addition to tissue factor expression, CD147 is crucial in promoting the potential of extracellular vesicles to induce MMP-mediated extracellular matrix degradation and, consequently, cell invasion, thereby allowing metastatic disease progression."

Bladder Cancer • Oncology • Solid Tumor • Urothelial Cancer • BSG

The OAT-RCT study: the obesity anticoagulation thromboprophylaxis randomized controlled trial protocol. (PubMed, Int J Surg Protoc) - "The OAT-RCT is the first adequately powered head-to-head randomized controlled trial comparing anti-Xa levels of tinzaparin and enoxaparin for VTE prophylaxis in bariatric surgery. The results will provide high-quality class I evidence to inform evidence-based prescribing guidelines for this rapidly growing surgical population."

Journal • Cardiovascular • Gastrointestinal Disorder • Genetic Disorders • Obesity • Venous Thromboembolism

The PARTUM Trial: Postpartum Aspirin to Reduce Thromboembolism Undue Morbidity (clinicaltrials.gov) - P3 | N=8805 | Recruiting | Sponsor: University of Calgary | Not yet recruiting ➔ Recruiting

Enrollment open • Cardiovascular • Venous Thromboembolism

During pregnancy, anticoagulant effect of low molecular weight heparin can be determined with both thrombelastography and anti-factor Xa activity, or not? (PubMed, Anaesth Intensive Care) - "Sixteen pregnant women were administered dalteparin or tinzaparin from early pregnancy until six weeks postpartum. However, the correlation between the two methods is too low to allow replacement of one by the other. Further studies are necessary to determine which of the methods best predicts anticoagulant effect and increased risk of bleeding complications related to delivery or regional anaesthesia."

Journal • Anesthesia • Cardiovascular • Venous Thromboembolism

Unintentional Anticoagulant Overlap: A Clinical and Laboratory Pitfall (ISTH 2026) - "It was later established that, due to a misunderstanding of discharge instructions after first ED visit, the patient continued apixaban 5mg BID alongside tinzaparin, on D1-2. Systematic clinical reconciliation and the use of specific assays are essential to avoid misdiagnosis and the administration of potentially thrombogenic reversal agents in patients with recent thrombosis. Table or Figure Upload (1) Table 1 Page 2 DOI*10.1016/j.rpth.2026.106519"

Clinical • Genito-urinary Cancer • Hemophilia • Prostate Cancer • Rare Diseases • Solid Tumor • Thrombosis

In Vitro Evaluation of Anticoagulant Agents to Enhance Anticancer Treatment Efficacy by Disrupting Fibrin-Clot Shields in the Tumor Microenvironment (ISTH 2026) - "Aims To determine whether clinically relevant concentrations of tinzaparin or apixaban can abrogate the protective effect of CaCe–induced FCS against paclitaxel (PTX) and 4-hydroxytamoxifen (4OHTam) by modulating FCS formation and structure. These findings support targeting TF-driven, cancer-associated fibrin architecture as a complementary strategy to enhance anticancer drug effectiveness, warranting further mechanistic and translational evaluation. DOI*10.1016/j.rpth.2026.106236"

Preclinical • Tumor microenvironment • Oncology

Bridging or No Bridging for Perioperative Management of Patients with a Mechanical Aortic Valve (ISTH 2026) - "Background The perioperative management of warfarin-treated patients with a mechanical aortic valve who need warfarin interruption for an elective surgery is uncertain, specifically as to the need for bridging, typically with a low-molecular-weight heparin (LMWH), or no bridging...Bridging was defined as administration, based on dispensed prescriptions, of ≥1 dose of a full/therapeutic-dose LMWH regimen before surgery, with either enoxaparin, dalteparin or tinzaparin...Additional, well- designed prospective studies are needed to assess the safety of a no bridging strategy in such patients. Table or Figure Upload (1) Outcomes in Bridged and Not Bridged Patients (*values of 1-5 suppressed to preserve privacy) Outcome Unweighted Weighted Bridged (n=298) Not Bridged (n=238) Bridged Not Bridged Stroke *1-5 0 0.74% 0.00% TIA *1-5 0 0.25% 0.00% Page 2 VTE *1-5 *1-5 0.69% 0.49% MI *1-5 0 0.34% 0.00% Intracranial bleed *1-5 *1-5 0.27% 0.63% Gastrointestinal bleed 2.35% *1-5 1.99%..."

Clinical • Cardiovascular

A pilot prospective safety and feasibility study of delivering anticoagulation (ACT) in children at risk of thrombocytopenia: Preliminary Findings (ISTH 2026) - "Approved by the Hamilton Integrated Research Ethics Board and informed consent (and assent) was obtained for every participant. Table or Figure Upload (1) Table 1 Clinical Characteristics of Patients Enrolled Demographics Age Median 7.5y (Range 2-17y) Sex 9 male & 11 female Thrombosis Location DVT 14 PE 2 Superficial Vein 1 Intracardiac 3 Anticoagulant* Enoxaparin 18 Tinzaparin 4 Rivaroxaban 8 Apixaban 1 Page 2 *Includes switches between anticoagulation DOI*10.1016/j.rpth.2026.104983"

Clinical • Hematological Disorders • Thrombocytopenia

Defining Hypercoagulability in Patients with Surgically-Managed Diaphyseal Tibia Fractures: A Pilot Study (ISTH 2026) - "Tinzaparin was administered throughout admission in 70% of patients and 77% received two weeks of outpatient acetylsalicylic acid. Table or Figure Upload (1) Figure 1: Serial thrombelastography, indicating early and prolonged hypercoagulable state (maximal amplitude [MA] of 65mm or greater). Page 2 DOI*10.1016/j.rpth.2026.104558"

Clinical • Cardiovascular • Hematological Disorders • Musculoskeletal Diseases • Orthopedics • Respiratory Diseases • Venous Thromboembolism

Enoxaparin, Tinzaparin, and Apixaban Modulate Cancer Cell Procoagulant Activity and Viability: Comparison with Quercetin. (PubMed, Cancers (Basel)) - " These findings suggest that LMWHs, apixaban, and quercetin modulate cancer-cell-driven hypercoagulability beyond anticoagulation, with quercetin and tinzaparin showing additional cytotoxic potential. Such dual effects may reduce thrombosis risk while impacting tumor progression, meriting further investigation."

Journal • Breast Cancer • Cardiovascular • Hematological Disorders • Oncology • Pancreatic Cancer • Thrombosis

Pulmonary Embolism & Anticoagulation Evaluation in Cancer Patient - PEACE (clinicaltrialsregister.eu) - P4 | N=234 | Not yet recruiting | Sponsor: Region Hovedstaden

New P4 trial • Cardiovascular • Oncology • Pulmonary Embolism • Respiratory Diseases

THRomboprophylaxis in Individuals Undergoing Superficial endoVEnous Treatment (THRIVE) (clinicaltrials.gov) - P4 | N=3175 | Recruiting | Sponsor: Imperial College London | N=6660 ➔ 3175

Enrollment change • Cardiovascular • Varicose Veins • Venous Thromboembolism

Direct oral anticoagulants versus low-molecular-weight heparin for venous thromboembolism in primary brain tumors: A TriNetX real-world analysis. (ASCO 2026) - "Cohorts included patients treated with DOACs (apixaban, rivaroxaban, edoxaban, or dabigatran) or LMWH (enoxaparin, dalteparin, or tinzaparin) after VTE diagnosis. In this large real-world cohort of adults with primary brain malignancy and VTE, DOAC treatment was associated with a lower intracranial hemorrhage risk and reduced mortality at 180 days compared with LMWH after propensity score matching. These findings support the safety of DOACs in patients with primary brain tumors and warrant further prospective evaluation of anticoagulant selection in this high-risk population."

Clinical • Real-world • Real-world evidence • Brain Cancer • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Diabetes • Genetic Disorders • Metabolic Disorders • Nephrology • Obesity • Oncology • Renal Disease • Solid Tumor • Venous Thromboembolism

GIT-PRo-2022-02: Prophylaxis of venous thromboembolic disease with LMWH (TINzaparin) in patients with metastatic colorectal cancer who start the first line of treatment. (clinicaltrialsregister.eu) - P2/3 | N=631 | Completed | Sponsor: Grupo Gallego De Investigacion En Tumores Digestivos | Recruiting ➔ Completed

Trial completion • Cardiovascular • Colon Cancer • Colorectal Adenocarcinoma • Colorectal Cancer • Oncology • Rectal Adenocarcinoma • Solid Tumor • BRAF

Thromboinflammatory and Pharmacological Effects of Low-Molecular-Weight Heparins in Acute Venous Thromboembolism: An Integrated Clinical and In Silico Analysis. (PubMed, Med Sci (Basel)) - "This study compared enoxaparin, bemiparin, and tinzaparin and explored potential multi-target mechanisms using molecular docking, network pharmacology, and enrichment analyses. LMWH therapy was associated with improved thromboinflammatory markers and clinical recovery, with tinzaparin showing comparatively more favorable thromboinflammatory biomarker trajectories and recovery dynamics within the limitations of this observational analysis. Integrated clinical and in silico findings provide hypothesis-generating insights into potential multi-target pharmacological effects beyond anticoagulation; however, these observations should be interpreted cautiously and require experimental validation."

Biomarker • Journal • Retrospective data • Cardiovascular • Inflammation • Pain • Venous Thromboembolism • IL6

The OAT-RCT: The OAT Trail: The Obesity Anti-Coagulation Thromboprophylaxis Trial. (clinicaltrials.gov) - P=N/A | N=180 | Not yet recruiting | Sponsor: University College Dublin | Initiation date: May 2026 ➔ Aug 2026

Trial initiation date • Cardiovascular • Genetic Disorders • Obesity • Venous Thromboembolism

Tinzaparin And Biomarkers After Neoadjuvant Treatment of Ovarian Cancer (clinicaltrials.gov) - P2 | N=40 | Recruiting | Sponsor: University Hospital, Linkoeping | Trial completion date: Dec 2026 ➔ Dec 2027 | Trial primary completion date: Dec 2026 ➔ Dec 2027

Biomarker • Trial completion date • Trial primary completion date • Epithelial Ovarian Cancer • Oncology • Ovarian Cancer • Solid Tumor

The OAT-RCT Study: The Obesity Anti-Coagulation Thromboprophylaxis Randomised Controlled Trial. (clinicaltrials.gov) - P=N/A | N=180 | Not yet recruiting | Sponsor: University College Dublin

New trial • Cardiovascular • Genetic Disorders • Obesity • Venous Thromboembolism

THRomboprophylaxis in Individuals Undergoing Superficial endoVEnous Treatment (THRIVE) (clinicaltrials.gov) - P4 | N=6660 | Recruiting | Sponsor: Imperial College London | Trial completion date: Dec 2026 ➔ Dec 2027 | Trial primary completion date: Jun 2026 ➔ Jun 2027

Trial completion date • Trial primary completion date • Cardiovascular • Varicose Veins • Venous Thromboembolism

The Intensive Care Platform Trial (INCEPT) (clinicaltrialsregister.eu) - P4 | N=40000 | Recruiting | Sponsor: Rigshospitalet

New P4 trial • Critical care

Heparin-incorporated whey protein isolate-derived hydrogels with an intended dual function as snakebite wound dressings and drug delivery systems inhibit spitting cobra venom-induced cytotoxicity. (PubMed, Toxicon) - "Herein we introduce the concept of integrating heparins, specifically unfractionated heparin (H) and its low molecular weight heparinoid variant, tinzaparin (T), into hydrogels composed of whey protein isolate (WPI), an inexpensive byproduct of the dairy industry that is cytocompatible, stiff, sterilizable by autoclaving, and that has the dual function of being able to locally deliver drugs and act as wound dressings...Most importantly, sufficiently high concentrations of T were released into phosphate buffered saline from the 10% T hydrogels to neutralise Naja nigricollis venom cytotoxicity in a HaCaT cell cytotoxicity model. Together, our results suggest that the integration and diffusion of venom-inhibiting drugs in WPI hydrogels is possible and that the development of such drug-integrated hydrogels into snakebite wound dressings warrants further research."

Journal

Complications in Cancer Associated Thrombosis patients on tinzaparin by cancer site and frailty: a pooled analysis. (PubMed, Blood Adv) - "In patients with CAT receiving tinzaparin, VTE recurrence, unlike bleeding risk, varies according to tumor site and patient frailty.. In CAT patients with frailty treated with standard full-dose tinzaparin, these findings do not support routine dose modification."

Journal • Retrospective data • Breast Cancer • Cardiovascular • Gynecologic Cancers • Hematological Disorders • Oncology • Solid Tumor • Thrombosis • Venous Thromboembolism

The effect of tinzaparin sodium and leuprolide acetate in an experimental mouse model of endometriosis: The rol of the WNT/beta-catenin pathway. (PubMed, Turk J Obstet Gynecol) - "WNT2 and HIF1a immunostaining revealed greater reductions in score in the tnz7d group compared with controls and other treatment arms, but these differences were not statistically significant. Further investigation is warranted to determine how tinzaparin sodium and leuprolide acetate modulate the WNT/β-catenin axis for the management of endometriosis."

Journal • Preclinical • Endometriosis • Gynecology • Inflammation • Women's Health • HIF1A • WNT2