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CARPHOLOGY by Rajendra

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Preventing venous thromboembolism

The good thing about idraparinux is that can be given once a week by subcutaneous injection. The unfortunate thing is that although it can prevent deep vein thrombosis it cannot prevent pulmonary embolism. These are the findings from two randomised, open-label non-inferiority trials including 2904 patients with deep vein thrombosis and 2215 patients with pulmonary embolism which compared idraparinux to heparin plus a vitamin K antagonist. The primary efficacy outcome was the three-month incidence of symptomatic recurrent venous thromboembolism. Neurologists would of course like to know if idraparinux works for the primary prevention of deep vein thrombosis in patients with neurological illnesses.

N Engl J Med 2007;357:1094–104.

Delaying multiple sclerosis

A two-phase trial including 468 patients with a first event suggestive of multiple sclerosis shows that early treatment with interferon beta-1b delays conversion to clinically definite multiple sclerosis. The recruited patients had a minimum of two clinically silent lesions on magnetic resonance imaging. The initial early treatment phase lasted two years and …

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