Тинзапарин

[chuka_lis]

Клинические испытания тинзапарина (2 слепое рандомизированное мультицентральное) для взсрослых с ковидной пнемонией ( 300 госпитализированных, но не в критическом состоянии) показали, что  прием препарата в профилактических,  умеренных или теравпевтических  дозах не  особо влияет на картину появления тромбов (тромбоэмболии) или ковидные осложнения (необоходимость в доп вентиляции легких, включая ИВЛ, смерть в течении месяца) у таких больных.
Во всех группах, включая плацебо, тромбы случались примерно у каждого 5-6.
Сильных кровотечений в группе так же не наблюдалось, небольшие были у 3.7%, так что прием тинзапарина можно считать безопасным, хоть и не особо эффективным.
Hospitalized patients with COVID-19 are at increased risk for thrombosis, acute respiratory distress syndrome and death. The optimal dosage of thromboprophylaxis is unknown. Objective: To evaluate the efficacy and safety of tinzaparin in prophylactic, intermediate, and therapeutic doses in non-critical patients admitted for COVID-19 pneumonia. Design, setting, and participants : Randomized controlled, multicenter trial (PROTHROMCOVID) enrolling non-critical, hospitalized adult patients with COVID-19 pneumonia. Interventions: Patients were randomized to prophylactic (4500 IU), intermediate (100 IU/kg), or therapeutic (175 IU/kg) doses of tinzaparin during hospitalization, followed by 7 days of prophylactic tinzaparin at discharge. Measurements: The primary efficacy outcome was a composite endpoint of symptomatic systemic thrombotic events, need for invasive or non-invasive mechanical ventilation, or death within 30 days. The main safety outcome was major bleeding at 30 days. Results : Of the 311 subjects randomized, 300 were included in the analysis (mean [SD] age, 56.7 [14.6] years; males, 182 [60.7%]. The composite endpoint at 30 days from randomization occurred in 58 patients (19.3%) of the total population; 19 (17.1 %) in the prophylactic group, 20 (22.1%) in the intermediate group, and 19 (18.5%) in the therapeutic dose group (P= 0.72). No major bleeding event was reported; non-major bleeding was observed in 3.7% of patients, with no intergroup differences.   Conclusions: In non-critically ill COVID-19 patients, intermediate or full-dose tinzaparin compared to standard prophylactic doses did not appear to increase benefit regarding the likelihood of thrombotic event, non-invasive ventilation or high-flow oxygen, or death.