Repeated Oral or Subcutaneous LMWH Has similar Antithrombotic Activity in a Rat Venous Thrombosis Model: Antithrombotic Activity Correlates With Heparin on Endothelium When Orally Administered.

Low-molecular-weight heparins (LMWHs) endure as important drugs for thromboprophylaxis. Although clinical use relies on the subcutaneous (SC) route, our previous studies show that single-dose orally administered LMWHs have antithrombotic activity. Since thromboprophylaxis requires long-term treatment, we examined antithrombotic effects of subacute oral LMWHs in a rat venous thrombosis model and compared results to SC or single-dose oral administration. We measured LMWH in endothelium and plasma, weight change and complete blood counts (CBC). Oral LMWH tinzaparin (3 × 0.1 mg/kg/12 or 24 hours) or reviparin (3 × 0.025 mg/kg/24 hours) significantly decreased thrombosis compared to saline. In the subacute study (60 × 0.1 mg/kg/12 hours), oral or SC tinzaparin significantly reduced thrombosis compared to saline but not to single or 3 × 0.1 mg/kg/12 hours oral tinzaparin. Antithrombotic effects were similar between oral and SC administration. LMWH was found on endothelium following oral but not SC administration. Endothelial concentrations were significantly correlated with incidence of stable thrombi ( P = 0.021 and 0.04 for aortic and vena cava endothelium respectively, χ2 test) and total thrombi ( P = 0.003 for vena cava endothelium). Anti-Xa activity was significantly greater for oral or SC LMWH than saline and significantly greater for SC versus oral LMWH. Values for CBCs were within normal ranges (mean ± 2 SD). There was no evidence of bleeding. Weight gain was similar between groups. In conclusion, subacute oral and SC LMWH have similar antithrombotic effects. Antithrombotic activity with oral administration is correlated with endothelial LMWH concentrations but not with plasma anticoagulant activity.

Pharmacokinetics of tinzaparin (Logiparin)--a low molecular weight heparin--after single and repeated intravenous administration in rats.

After a single and repeated i.v. injections of 1 mg/kg 3H-radiolabelled tinzaparin once daily to rats for 7, 14, and 21 days, drug-related radioactivity in plasma, tissues, urine and faeces was measured by use of liquid scintillation counting. The decay in plasma could be described by a three-compartment model with half-lives of the two distributive phases and the terminal elimination phase of 15 min, 90 min, and 37 hrs, respectively. The peak plasma concentration did not change during repeated dosing, as opposed to the trough concentration which increased 3 fold. The decay in tissues was significantly different from that in plasma, and showed less fluctuations. Drug-related radioactivity accumulated gradually with repeated dosing, reaching accumulation ratios between 5 and 9, when based on trough concentrations. Slow elimination was observed from tissues, and significant amounts were still present 14 days after discontinuation of the repeated dosing. In the liver, the concentrations were almost constant during a dosing interval. After a single injection, 86% and 4% of the administered radioactive dose were excreted in urine and faeces over 7 days, respectively, the majority being recovered during the first 24 hrs, demonstrating that the major route of elimination was by renal excretion. The molecular mass distribution of radioactivity in urine was similar but not identical to the injected test substance. It was shifted slightly towards lower molecular mass and had no anti-factor Xa activity, suggesting that the heparin was either inactivated, presumably by desulphation, or that the antithrombin binding portion of the drug was cleared through a different route.

Detection of the low molecular weight heparin component of ITF 1300 in urines after intranasal administration to dogs.

GAGs were purified from urine of dogs after intranasal administration of 40 mg/kg ITF 1300. The electrophoretic patterns of urine GAGs in acidic buffer showed the presence of heparin together with chondroitins, heparan sulfate, and hyaluronic acid. The heparin present in urines was purified using chondroitinase ABC, and its purity was tested by electrophoresis in acidic buffer. The sample obtained was characterized by 13C-NMR, showing the same characteristic signals of the heparin starting material.

Pharmacokinetics and biodistribution of technetium 99m labelled standard heparin and a low molecular weight heparin (enoxaparin) after intravenous injection in normal volunteers.

For a better understanding of low molecular weight heparin pharmacokinetics, 99m technetium labelled heparin and enoxaparin were injected intravenously to four normal volunteers, after approval by the Ethics Committee and preliminary animals studies. In vitro and in vivo, the labelled products proved to be stable and identical to the non-labelled drugs. Radioactivity curves in blood, organs and urines were similar for both products. Anti Xa plasma half-life was 3 times longer for enoxaparin than for heparin. Anti IIa plasma half-lives were similar. However, radioactivity persisted much longer than biological activities for both products. After chromatography, most of the radioactivity was bound to AT III, where an anti Xa activity peak was also detected. The anti Xa activity peak seen after adding AT III to plasma was much higher with heparin than with enoxaparin. In urine, biological activities, measured with AT III supplementation, were higher with enoxaparin than with heparin. These results suggest that phenomena other than biodistribution are responsible for the differences in pharmacokinetics observed between these two products. The two most likely explanations are differences in metabolism and/or a release of an endogenous factor.

Impaired sulphated glycosaminoglycan metabolism in a patient with GM-2 gangliosidosis (Tay-Sachs disease).

An abnormal urinary excretion of sulphated glycosaminoglycans in a patient with GM-2 gangliosidosis (Tay-Sachs disease) is described. Besides the accumulation of GM-2 ganglioside in liver and lack of hexosaminidase A, the patient shows an abnormal urinary excretion of an iduronic acid-rich low molecular weight heparan sulphate. Also, no dermatan sulphate could be detected in the urine, whereas this compound was the main sulphated glycosaminoglycan in the liver of the patient. Heparan sulphate was the main glycosaminoglycan of normal liver. The total amount of sulphated glycosaminoglycans in the urine and liver of the patient did not differ significantly from the amounts found in the liver and urine of normal subjects. Several plasma glycosidases have been assayed and the activities did not differ significantly from the values obtained for the plasma of normal subjects.