Does Desirudin work?
Yes, in large controlled trials, including one of 2,079 patients.
Approval rested on randomized double-blind trials in hip replacement. The larger one randomized 2,079 patients across 31 European centres and found fewer proximal deep vein thromboses with desirudin (4.5%) than with enoxaparin (7.5%), with venography confirming every diagnosis; a 445-patient trial found a larger advantage over unfractionated heparin. 13
Eriksson and colleagues randomized 2,079 patients having planned total hip replacement. They worked at 31 centres in 10 countries. Patients got desirudin or enoxaparin for 8 to 12 days. At the end, venography of both legs looked for clots. In the 1,587 patients with usable venograms, deep vein thrombosis near the hip occurred in 4.5% on desirudin and 7.5% on enoxaparin. That is a 40% relative drop. Any deep vein thrombosis occurred in 18.4% against 25.5%. Safety, including bleeding, was similar in the two groups. 1
An earlier double-blind trial randomized 445 hip replacement patients to desirudin or unfractionated heparin. Among the 351 with adequate venograms, deep vein thrombosis occurred in 7% on desirudin and 23% on heparin. Clots near the hip occurred in 3% against 16%. Bleeding did not differ. 3
Evidence checklist
- Randomised controlled trial Double-blind vs enoxaparin after hip surgery
- Human study over 100 people 2,079 hip replacement patients
- More than one research group One main trial plus earlier heparin trial
- Clinical outcomes, not surrogate markers Venography-confirmed clots
- Human safety data beyond case reports Bleeding and antibodies tracked in trials
More on Desirudin
Citations
- Eriksson 1997, N Engl J Med: recombinant hirudin (desirudin) versus enoxaparin to prevent thromboembolism after total hip replacement pubmed.ncbi.nlm.nih.gov
- Drugs.com: Iprivask (desirudin), discontinued drugs.com
- Eriksson 1997, J Bone Joint Surg Am: desirudin versus unfractionated heparin after total hip replacement doi.org
Reference information only, not medical advice. Drawn from the Desirudin article, fact-checked against the cited sources. No dosing anywhere on this site.