Innohep (tinzaparin) / LEO Pharma - LARVOL DELTA

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)."

Aticks Live: Effect of Tinzaparin on Inflammatory Biomarkers During the Acute Phase of Deep Vein Thrombosis (clinicaltrials.gov) - P=N/A | N=9 | Active, not recruiting | Sponsor: Centre Hospitalier Universitaire, Amiens | Completed ➔ Active, not recruiting | Trial completion date: Nov 2023 ➔ Nov 2025

Biomarker • Enrollment closed • Trial completion date • Cardiovascular • Hematological Disorders • Inflammation • Thrombosis • Venous Thromboembolism

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 • Cardiovascular • Hematological Malignancies • Multiple Myeloma • Oncology

Reduced Anticoagulation Targets in ECLS (RATE) (clinicaltrials.gov) - P3 | N=330 | Completed | Sponsor: University Medical Center Groningen | Recruiting ➔ Completed | Trial completion date: Mar 2024 ➔ Mar 2025 | Trial primary completion date: Mar 2023 ➔ Mar 2025

Trial completion • Trial completion date • Trial primary completion date • Cardiovascular • Heart Failure • Hematological Disorders • Respiratory Diseases • Thrombosis

Hemorrhagic shock after dental extractions in a patient with anticoagulant and antiplatelet therapy: a case report. (PubMed, Int J Surg Case Rep) - "Precautions for hemostasis during the intervention are important but sometimes insufficient. For patients at high risk of bleeding with comorbidity like anticoagulant and antiplatelet therapy, it is necessary to establish 7-day postoperative monitoring to control possible post-operative bleeding."

Journal • Cardiovascular • Hematological Disorders • Oncology

Influence of anticoagulant concomitant medication on wound healing: Analysis of a multicentre cohort of 212 patients with a uniform wound model. (PubMed, Br J Clin Pharmacol) - "Enoxaparin and nadroparin may enhance wound healing, whereas phenprocoumon, acetylsalicylic acid, and certain low-molecular-weight heparins (certoparin, tinzaparin, dalteparin, bemiparin) appear to delay wound healing. Anticoagulant monotherapy with enoxaparin or nadroparin should be considered postoperatively when feasible."

Journal

An Experimental Study to Assess the Ecotoxicity of Warfarin and Tinzaparin on Meiobenthic Amphipods: Original Taxonomic Data from Saudi Arabia and Computational Modeling. (PubMed, Toxics) - "Ultimately, the similarity between the control amphipod replicates and those subjected to mixed anticoagulants (T1W1 and T2W2) suggests that warfarin may have reduced the toxicity of tinzaparin. Additionally, the computational study indicated that warfarin interacts with 4XNN and forms strong molecular interactions with several key residues, which contribute to the toxicokinetic characteristics observed in the empirical findings."

Journal

Comparison of Prophylactic and Therapeutic Doses of Anticoagulation for Acute Chest Syndrome in Sickle Cell Disease: The TASC Randomized Clinical Trial. (PubMed, Am J Respir Crit Care Med) - P3 | "In adult patients with ACS, a therapeutic anticoagulation shortened ACS duration and reduced opioids consumption compared with prophylactic doses, without increasing bleeding risk. Clinical trial registration available at www."

Clinical • Journal • Cardiovascular • Genetic Disorders • Hematological Disorders • Sickle Cell Disease • Thrombosis

Aticks Live: Effect of Tinzaparin on Inflammatory Biomarkers During the Acute Phase of Deep Vein Thrombosis (clinicaltrials.gov) - P=N/A | N=9 | Completed | Sponsor: Centre Hospitalier Universitaire, Amiens | Recruiting ➔ Completed

Trial completion • Cardiovascular • Hematological Disorders • Inflammation • Thrombosis • Venous Thromboembolism

The PARTUM Trial: Postpartum Aspirin to Reduce Thromboembolism Undue Morbidity (clinicaltrials.gov) - P3 | N=8805 | Not yet recruiting | Sponsor: University of Calgary | Initiation date: Sep 2024 ➔ Apr 2025

Trial initiation date • Cardiovascular • Venous Thromboembolism

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. (PubMed, Eur J Surg Oncol) - "In the PERIOP-01 trial, extended thromboprophylaxis did not reduce the incidence of major VTE in any subgroups of patients. However, this strategy may be associated with an increased incidence of bleeding among patients with colon cancer, and perhaps among male and elderly patients."

Journal • Retrospective data • Cardiovascular • Colon Cancer • Colorectal Cancer • Hematological Disorders • Oncology • Solid Tumor • Venous Thromboembolism

Preferences for thromboprophylaxis in the intensive care unit: An international survey. (PubMed, Acta Anaesthesiol Scand) - "LMWH was the preferred agent for thromboprophylaxis in critically ill patients. There was considerable variation in the application of LMWH for prophylaxis, reflected by the use of different types, doses, and dosing strategies. Most physicians would be willing to participate in an RCT on thromboprophylaxis."

Clinical • Journal • Cardiovascular • Critical care • Venous Thromboembolism

PREPOSTEROUS: Pre- Vs Postoperative Thromboprophylaxis for Liver Resection (clinicaltrials.gov) - P4 | N=1012 | Recruiting | Sponsor: Helsinki University Central Hospital | Trial completion date: Mar 2025 ➔ Mar 2027 | Trial primary completion date: Feb 2025 ➔ Feb 2027

Trial completion date • Trial primary completion date • Cardiovascular • Hematological Disorders • Hepatology • Liver Cancer • Oncology • Pulmonary Embolism • Solid Tumor • Thrombosis

Treatment of radial artery occlusion after transradial coronary catheterization: a review of the literature and proposed treatment algorithm. (PubMed, Hellenic J Cardiol) - "There are only two randomized studies one with LMWH (tinzaparin) and one with apixaban. Therapeutic options include anticoagulation regimens and interventional techniques through the distal radial artery. Large, randomized, multicenter studies should be conducted to evaluate the efficacy of the available treatment methods and define a standardized treatment protocol for RAO."

Journal • Review

ACTIV-4: Accelerating COVID-19 Therapeutic Interventions and Vaccines 4 ACUTE (clinicaltrials.gov) - P4 | N=3591 | Completed | Sponsor: Matthew Neal MD | Active, not recruiting ➔ Completed | Trial completion date: Jun 2024 ➔ Jan 2024

Trial completion • Trial completion date • Infectious Disease • Novel Coronavirus Disease

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 • Hematological Disorders • Obesity • Oncology • Pediatrics • Venous Thromboembolism

TiLLI: Thromboprophylaxis in Lower Limb Immobilisation (clinicaltrials.gov) - P3 | N=10044 | Recruiting | Sponsor: Queen Mary University of London | Not yet recruiting ➔ Recruiting

Cost effectiveness • Enrollment open • HEOR • Cardiovascular • Hematological Disorders • Thrombosis

Impact of Residual Vein Venous Thrombosis in Consecutive Patients with Cancer-Associated Thrombosis Treated with Tinzaparin-A Cohort Study. (PubMed, Cancers (Basel)) - " RVT is high in patients with CAT. The presence of RVT at 6 months was associated with an increased risk of recurrent VTE over 5 years."

Journal • Cardiovascular • Hematological Disorders • Oncology • Respiratory Diseases • Thrombosis • Venous Thromboembolism

Fondaparinux: A Cost-Saving Alternative to Low-Molecular-Weight Heparins for Venous Thromboembolic Event Prevention/Treatment and Acute Coronary Syndrome Treatment (ISPOR-EU 2024) - " Our model estimates per-patient costs and budget impact of fondaparinux versus LMWHs (enoxaparin, nadroparin, tinzaparin, parnaparin) for treatment and prevention of VTE and treatment of ACS. Avoidance of HIT-related costs results in cost-savings with fondaparinux compared with LMWH across all indications which can provide substantial budget savings. Further analysis will demonstrate potential cost savings with fondaparinux in other healthcare systems."

HEOR • Acute Coronary Syndrome • Cardiovascular • Hematological Disorders • Respiratory Diseases

Risk of recurrent venous thromboembolism in patients with cancer: an individual patient data meta-analysis and development of a prediction model. (PubMed, Thromb Haemost) - "Results After excluding patients using vitamin K antagonists, the combined dataset comprised 2,245 patients with cancer and acute CAT who were treated with edoxaban (23%), rivaroxaban (9%), dalteparin (47%), or tinzaparin (20%). Conclusions The prediction model for recurrent CAT included five clinical predictors and has only modest discrimination. Prediction of recurrent CAT at the initiation of anticoagulation remains challenging."

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

Effects of tinzaparin on the presence of residual thrombus in patients with cancer-associated thrombosis (ERS 2024) - "One-third of cancer-associated VTE patients have residual thrombosis, with identified variables associated with residual thrombosis."

Clinical • Cardiovascular • Hematological Disorders • Oncology • Respiratory Diseases • Thrombosis • Venous Thromboembolism

TiLLI: Thromboprophylaxis in Lower Limb Immobilisation (clinicaltrials.gov) - P3 | N=10044 | Not yet recruiting | Sponsor: Queen Mary University of London | Trial completion date: Feb 2028 ➔ Aug 2028 | Initiation date: May 2024 ➔ Sep 2024 | Trial primary completion date: Feb 2028 ➔ Aug 2028

Cost effectiveness • HEOR • Trial completion date • Trial initiation date • Trial primary completion date • Cardiovascular • Hematological Disorders • Thrombosis

The effect of tinzaparin on biomarkers in FIGO stages III-IV ovarian cancer patients undergoing neoadjuvant chemotherapy - the TABANETOC trial: study protocol for a randomized clinical multicenter trial. (PubMed, Acta Oncol) - "This study will make an important contribution to the knowledge of the anti-neoplastic effects of tinzaparin in EOC patients and may thus guide the planning of a future study on the impact of tinzaparin on survival in EOC."

Biomarker • Clinical • Clinical protocol • Journal • Gynecology • Obstetrics • Oncology • Ovarian Cancer • Solid Tumor

Tinzaparin, an alternative to subcutaneous unfractionated heparin, in patients with severe and end-stage renal impairment: a retrospective observational single-center study. (PubMed, J Thromb Haemost) - "Tinzaparin PK parameters and profiles were not affected by renal impairment. This suggests that tinzaparin, at therapeutic or prophylactic dose, could be an alternative to unfractionated heparin in hospitalized patients with severe renal impairment."

Journal • Retrospective data • Hematological Disorders • Nephrology • Renal Disease