NEJM EvidenceEnoxaparin versus Placebo to Prevent Symptomatic Venous Thromboembolism in Hospitalized Older Adult Medical Patients

VTE affects 1.6 out of 1000 people annually, with hospitalization being a key risk factor.

The SYMPTOMS trial was a prospective, randomized, placebo-controlled, multicenter, international study designed to evaluate the efficacy of low-molecular-weight heparin in preventing symptomatic venous thromboembolism (VTE) in older adults hospitalized for acute medical conditions.

Key Points:

• The SYMPTOMS trial was performed with older adults (70 years or older) hospitalized for acute medical conditions.
• The trial employed a randomized, placebo-controlled design to assess the efficacy of low-molecular-weight heparin.
• The primary efficacy outcome was symptomatic confirmed VTE or fatal pulmonary embolism through day 30.
• There was no significant difference observed in the primary efficacy outcome between the enoxaparin and placebo groups.

Additional Points:

• The median age of participants was 82 years.
• The median duration of trial drug administration was 7 days.
• The secondary efficacy outcome, symptomatic confirmed VTE or fatal pulmonary embolism through day 90, saw a slightly lower incidence in the enoxaparin group.
• Major bleeding, the primary safety outcome, occurred in 0.9% of patients in the enoxaparin group and 1.0% of patients in the placebo group.

Conclusion:

• The SYMPTOMS trial did not find a significant difference in the incidence of symptomatic VTE or fatal pulmonary embolism in older adults hospitalized for acute medical conditions between those treated with enoxaparin and those given a placebo. The safety profile was comparable between the two groups.

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Did You Know?
Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is considered the third most common cardiovascular illness after acute coronary syndrome and stroke