Ultra Low Molecular Weight Heparins

Depolymerization of LMWHs has resulted in the development of ultra low LMWHs.

Several ultra-LMWHs have recently become available and are currently in development for specific indications.

Bemiparin is one such product that is efficacious in the management of DVT. Bemiparin represents a lower low molecular weight heparin which is derived from the same depolymerization process as enoxaparin.

Bemiparin has been evaluated in the management of venous thrombosis in both the medical and surgical settings. Additional clinical development of bemiparin is planned in both arterial and venous thrombosis.

Semuloparin represents an ultra low molecular weight heparin with a higher anti-Xa activity than enoxaparin and much lower anti-IIa activity. The molecular weight of octaparin is 2.4 KDA which is nearly half of enoxaparin, while the specific anti-Xa activity is 140 U/mg .

In a double-blind, multicenter trial, evaluated the efficacy and safety of the ultra-low-molecular-weight heparin semuloparin for prevention of venous thromboembolism in patients receiving chemotherapy for cancer.The authors concluded Semuloparin reduces the incidence of thromboembolic events in patients receiving chemotherapy for cancer, with no apparent increase in major bleeding.(N Engl J Med 2012; 366:601-609)

The implications of these agents on the perioperative course is not yet well defined and there is an new room for further research.

Chapman TM, Goa KL. Bemiparin: a review of it’s use in the prevention of venous thromboembolism and treatment of deep vein thrombosis.

Drugs 2003; 63: 2357-2377.

Laux V, Just M, Rosenburg R et al. and Viskov C.The new anticoagulant octaparin displays high antithrombotic action in venous thrombosis in rabbits and rats without impairment of hemostasis. J Thromb Hemost. 2005; 3: P0601

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