sanofi-aventis announced that the anticoagulant Clexane (enoxaparin sodium injection) has been approved for marketing in Japan by the Ministry of Health, Labour and Welfare for the prevention of venous thromboembolism (VTE) in patients undergoing orthopaedic surgery of the lower limbs such as total hip replacement, total knee replacement and hip fracture surgery.
Venous thromboembolism is a frequent and preventable complication among patients hospitalized for orthopaedic surgery. Deep vein thrombosis (DVT) and pulmonary embolism are common manifestations of VTE and can significantly impact morbidity and mortality in surgical patients. The Japanese VTE guidelines state that, without prophylaxis, between 27% and 50 per cent of orthopaedic surgery patients may suffer from deep vein thrombosis. Among the hospitalised patients at risk for VTE, 64 per cent are those undergoing surgery.
"In Japan, Clexane is expected to greatly contribute to the prevention of venous thromboembolis and fulfil an important medical need for patients undergoing orthopaedic surgery" said Hanspeter Spek, executive vice-president Pharmaceutical Operations of sanofi-aventis. "Clexane's approval illustrates the commitment of sanofi-aventis to bring new life saving drugs to patients in Japan, where further clinical trials are being conducted with Clexane to extend its use to abdominal surgery patients who are at risk for venous thromboembolic complications," he added.
Outside Japan with over 200 million patients treated in more than 100 countries, Clexane /Lovenox (enoxaparin sodium) is the most extensively studied and most widely used low-molecularweight heparin in the world. In venous thrombosis, Clexane/Lovenox is recommended by international guidelines not only in orthopaedic and general surgical patients at high and moderate risk of VTE but also, for acutely ill medical patients, and is an important treatment option for millions of patients at risk of VTE2. In arterial thrombosis, Clexane/Lovenox has demonstrated its effectiveness in preventing, in conjunction with other treatments, the ischaemic complications of unstable angina and myocardial infarction and is also recommended by international guidelines.
The no. 1 selling low-molecular weight heparin in the world, Clexane/Lovenox, is a unique chemical entity in a class of antithrombotic agents known as low-molecular weight heparins (LMWH). Its clinical applications are linked to its antithrombotic properties. It is used to inhibit clot formation in venous and arterial vessels to prevent potential acute or chronic complications of venous or arterial thrombosis.
The recommended dose regimen of Clexane in Japan is 20 mg b.i.d subcutaneous and has been established with the results of Japanese clinical trials.
Enoxaparin sodium is known by the brand name Lovenox or Clexane or Klexane and its labelling may vary country to country.
Venous thromboembolism is a general term used to describe the formation of a blood clot (thrombus) that blocks a vein. This may occur in any part of the venous system, but the most common manifestations are deep-vein thrombosis (DVT), usually in the leg, and pulmonary embolism (PE). PE is a potentially life-threatening complication of DVT; anyone who experiences DVT is at risk of a PE, which occurs when part or all of a blood clot in a deep vein breaks away from where it originally formed and travels through the venous circulation, eventually becoming lodged in the lungs. This blocks the flow of blood in the lungs and is often fatal. The total annual burden of non-fatal symptomatic VTE in the European Union, which included DVT and PE, is estimated to exceed 1.5 million events, including more than 500,000 deaths. This represents more than the double of the combined deaths due to AIDS, breast and prostate cancer and transport accidents.
In the United States, up to 2 million DVT events occur each year, and the development of PE causes up to 200,000 deaths annually. Fatal PE is the leading cause of sudden death among hospitalized patients and contributes to up to 10% of in-hospital deaths. In Japan, the population survey report by the Ministry of Health, Labour and Welfare showed that annual number of deaths from PE had sharply increased between 1988 to 2001 (591 to 1749 deaths).