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Thrombosis and critical ischemia

Low molecular weight heparin

Venous thromboembolism (VTE) represents a major clinical and social problem. In the general population it is estimated that the yearly incidence of Deep Venous Thrombosis (DVT) is of 69 cases out of 100,000 subjects. This incidence increases significantly in the population with cancer (1390 cases out of 100,000 subjects); in patients with cancer, DVT is the second cause of death.

In Italy, around 100 thousand patients are affected every year by acute syndrome coronary (ACS), term used to describe a variety of clinical conditions that include acute myocardial infarction and unstable angina: ACS is one of the most frequent reason of hospital admissions in the western world.

The activity of Italfarmaco in the prophylaxis and treatment of Venous Thromboembolism is consolidated by a long experience started with Calciparina, (unfractioned heparin (UFH)), and has its natural evolution in Nadroparin Calcium, (low molecular weight heparin (LMWH)), more flexible and with a comparable safety with UFH marketed by Italfarmaco with the brands Seleparina, Fraxiparina, Seledie e Fraxodi.

Since the beginning of 2019, Italfarmaco has strengthened its presence in this therapeutic area by introducing the first biosimilar of low molecular weight heparins, Enoxaparin Sodium, fully developed and produced in Italy, marketed under the trade names of Ghemaxan.

Ghemaxan is indicate for use in:

  • Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) (excluding PE likely to require thrombolytic therapy or surgery), serious conditions that occurs when a blood clot forms in a vessel;
  • Prophylaxis of venous thromboembolic disease in different clinical situation (moderate and high risk surgical patients, acute illness and reduced mobility);
  • Treatment of myocardial infarction and unstable angina, a type of discomfort caused by poor blood flow to the heart;
  • Prevention of thrombus formation in extra corporeal circulation during haemodialysis.

CRITICAL ISCHEMIA AREA

  • Endoprost: Iloprost is a synthetic prostacyclin analogue.

Iloprost is indicated for use in:

  • Treatment of advanced thromboangiitis obliterans (Bürger’s Disease) with critical ischemia of the extremities when revascularization is not indicated.
  • Treatment of Raynaud’s phenomenon following scleroderma.
  • Treatment of severe chronic arterial ischemia of the lower extremities, in patients with risk of amputation and when surgery and angioplasty are not indicated.
  • Fripass: Cilostazolo is a phosphodiesterase (PDE) III inhibitor with antiplatelet activity.
  • Fripass is indicated to increase the painless long distance walking and to improve the maximum walking distance in patients with claudicatio intermittens, painless at rest and without necrosis of the peripheral tissues (peripheral artery disease – Fontaine class II).
  • Fripass is indicated as a second-line treatment, in patients who, notwithstanding lifestyle changes (including abstention from smoking and physical exercise programs [with supervisor]) and other appropriate actions have not sufficiently improved the symptoms of claudicatio intermittens.
  • Fripass has the better global evidence of benefit in the treatment of patient with claudication.

The recommended dose of Fripass is of 100 mg twice daily. Fripass should be taken 30 minutes before breakfast and supper.
It is also available at the dose of 50 mg.