How to standardize low molecular weight heparins
Doutremepuich, C.; Puyal, C.; Lalanne, M.C.; Doutremepuich, F.; De Sèze, O.
Annales de Biologie Clinique 48(4): 221-225
1990
ISSN/ISBN: 0003-3898 PMID: 2163227 Document Number: 359266
Heparin, used in anticoagulant and antithrombotic therapeutic for over fifty years, turns out to mean important side effects and serious haemorrhagic risk. The obtaining, from 1976, of the first low molecular weight heparins (LMWH) preparations is partly allowed to overcome those problems. The LMWH present an identical or greater antithrombotic capacity than the unfractioned heparin and mean a lower haemorrhagic risk. Thus their use in antithrombotic therapy is very interesting. However, the existence of different units for the LMWH sets a standardization problem for their clinical use and for their biological follow up. The first international LMWH standard introduction by the World Health Organisation in 1986 may be useful to give a great homogeneity of the interlaboratory results, to serve as reference to the biologists, as activity standardization for the manufacturers or as security for the clinicians. However, it seems its definition mode and its validity call into question by several authors. The anti Xa activity, advocated in the biological surveillance, does not seem to perfectly fit to the LMWH therapy. The debate about the standardization of the low molecular weight heparins keeps open.