Evaluation of Anti-Xa Activity in Patients With Severe Obesity After Subcutaneous Injection of Enoxaparin for Antithrombotic Prophylaxis at Two Different Sites.

Evaluation of Anti-Xa Activity in Patients With Severe Obesity After Subcutaneous Injection of Enoxaparin for Antithrombotic Prophylaxis at Two Different Sites.

To evaluate appropriateness of enoxaparin bioavailability at two different sites of subcutaneous administration (arms or abdomen) in primary or secondary prevention of thromboembolism in a population of patients with severe obesity

Inclusion Criteria:• age >18 years,

• BMI >40 kg/m2
• indication to primary or secondary thromboprophylaxis (Padua Score > 4), as clinical practice

Exclusion Criteria:• indication to full dose anticoagulant,

• creatinine clearance <30 mL/min (based on Cockcroft-Gault equation using adjusted body weight),
• pregnant women,
• low platelet count (<50.000/microL or <100.000/microL plus additional risk factors for bleeding),
• active bleeding,
• active gastroduodenal ulcer,
• severe bleeding diathesis,
• recent/planned/emergency high bleeding-risk surgery/procedure,
• major trauma,
• acute intracranial hemorrhage,
• bleeding within the three months prior to admission,
• known hypersensitivity to enoxaparin (e.g. pruritus, urticaria, anaphylactic/anaphylactoid reactions),
• history of immune mediated heparin-induced thrombocytopenia (HIT),
• severe uncontrolled hypertension,
• diabetic or hemorrhagic retinopathy,
• concurrent administration of subcutaneous drugs (i.e. insulin, GLP-1 receptor agonists, etc.).