Development of blood clots following long-haul flights prevented with single dose of enoxaparin sodium

November 13, 2001

Chieti, Italy, London , UK - Deep-vein thrombosis (DVT) and pulmonary embolism, the potentially life-threatening disorders in which blood clots form primarily in the legs, were prevented in long-haul airline travelers with a history of heart disease through a single dose of the widely prescribed antithrombotic agent enoxaparin sodium (Clexane(R)/Lovenox(R)), according to a new study. The San Valentino Screening Project (the Italian equivalent of the well-known Framingham Heart Study) organised the study known as LONFLIT III. The entire LONFLIT research program includes more than 1500 subjects, each of whom experienced a flight of at least 10 hours in length.

LONFLIT III, an independently funded study, enrolled 300 people with a history of heart disease or stroke who were subsequently subjected to a plane flight of more than 10 hours in duration. Study participants were randomly assigned to receive either 400 mg of aspirin in one daily dose for three days (starting 12 hours before their flight), a single weight-adjusted dose (0.1 ml per 10 Kgs) of enoxaparin 2-4 hours prior their flight, or no preventive treatment. There were 52 patients who failed to complete the study after randomization and they were equally represented from among the three groups.

Among the 82 people receiving enoxaparin prior to their flights, there were no cases of DVT, and only one superficial clot (p<.002 in comparison with the other two groups). However, in the aspirin group, 3.6 percent of the 84 subjects had DVT, along with two superficial clots (p<.025), and in the no treatment control group, 4.8 percent of the 82 participants had DVT, along with two superficial clots. Participants underwent ultrasound scans within 24 hours before and after the flights to determine if DVT had occurred.

"These data suggest that a single dose of enoxaparin is an important consideration for high risk patients prior to a prolonged flight," said researcher Gianni Belcaro, PhD., of the University of Chieti in Chieti, Italy. "The dose of enoxaparin needed is low and can be easily injected into the subcutaneous tissue by the patient. Clearly, it should be prescribed for high-risk patients." The high-risk profile included those who had previous incidences of thrombosis, blood-clotting problems and circulatory problems in the legs, and coagulation disorders where high risk for DVT is well established.

The LONFLIT III study was funded by the San Valentino Vascular Screening Program, Italian Society for Vascular Investigations, European Venous Forum International Union of Angiology and University Funds. The study was conducted by an international group of researchers from the United Kingdom, Australia and Italy, and led by Dr. Belcaro. The results of this study were presented today at the American Heart Association's Scientific Sessions 2001 conference, one of the world's largest annual cardiology research meetings.

The previously conducted LONFLIT I study was designed to evaluate the occurrence of DVT as a consequence of long-haul flights. That study showed that no cases of DVT developed among 355 low-risk people, but that 19 of 389 high-risk people had blood clots (13 having DVT and 6 having superficial clots). The LONFLIT II study documented the effectiveness of wearing compression stockings as a way of preventing DVT in low-risk people. In this study, the incidence of DVT observed in subjects wearing compression stockings was 18.75 times lower than in the group who did not wear the stockings.

"Sitting in a cramped airplane seat for hours on end could result in a blood clot in a vein," said Belcaro. "Lack of mobility is the reason for the clot, but low pressure in the airplane cabin, low humidity and dehydration may also be contributing factors."
Contact:G Belcaro, MR Cesarone Dep Biomedical Sciences, Irvine2 Vasc Lab, GD'Annunzio University, Chieti, Italy, Ealing Hospital, Vascular Unit, St Mary's Hospital-Imperial College, London & Other Institutions
San Valentino 0039 085 8574944 Corso Umberto I, 18, San Valentino, 65020 Pe, Italy


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