Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Comparing the Efficacy of Two Frequently Used Doses of Enoxaparin for VTE Prophylaxis After Bariatric Surgery
Brief Summary: Approximately two thirds of the adult population in developed countries is categorized as over-weight or obese (BMI\>30). In spite of worldwide increasing awareness, obesity is a major health concern. In the presence of numerous diets, medical therapies, and robust research, bariatric surgery remains the most effective means of weight reduction in morbidly obese patients (BMI\>40, or BMI\>35 with co-morbidities). However, bariatric surgery harbors a relatively high risk for postoperative complications; of them, venous thromboembolic events (VTE) are not common, but potentially lethal. Taken together with the propensity of morbidly obese patients to develop VTE, perioperative thromboprophylaxis is mandatory.

To date, low molecular weight heparins (LMWH) are most commonly used for VTE prophylaxis in the aforementioned population. Due to the pharmacologic properties of LMWH and the characteristics of surgically treated obese patients, the optimal dose that is to be utilized for VTE prophylaxis in this population remains unclear. Assessment of anti-FXa levels in the patients' plasma can be used in order to monitor LMWH activity. Levels of 0.2-0.5 U/ml have been proposed by some authors for VTE prophylaxis.

Few studies have compared different dosing regimens of enoxaparin (between 30mg-60mg q/12h) for VTE prophylaxis in the population undergoing bariatric surgery; nevertheless, these were small non- randomized trials, containing numerous methodological weaknesses. Hence, the optimal regimen of enoxaparin to be used for the prevention of VTE in the discussed population remains unclear.

The aim of the present study is to evaluate plasma levels of anti-FXa activity, comparing two most commonly used enoxaparin prophylactic regimens (40mg vs 60mg q/24h) in a large and homogenous cohort of sleeve gastrectomy patients. Although universally used by bariatric surgeons, the pharmacologic efficacy of these regimens has not been evaluated in patients undergoing bariatric surgery.


Options:
A: Arm Label: 40mg Enoxaparin; Type: ACTIVE_COMPARATOR; Interventions: Drug: 40mg Enoxaparin | Arm Label: 60mg Enoxaparin; Type: ACTIVE_COMPARATOR; Interventions: Drug: 60mg Enoxaparin | Arm Label: Control; Type: OTHER; Interventions: Other: Control | Intervention Type: DRUG; Name: 40mg Enoxaparin; Assigned to Arm(s): 40mg Enoxaparin | Intervention Type: DRUG; Name: 60mg Enoxaparin; Assigned to Arm(s): 60mg Enoxaparin | Intervention Type: OTHER; Name: Control; Assigned to Arm(s): Control
B: Arm Label: Intensive anticoagulation strategy; Type: EXPERIMENTAL; Interventions: Drug: Anticoagulation Agents (Edoxaban and/or high dose LMWH) | Arm Label: Moderate anticoagulation strategy; Type: OTHER; Interventions: Drug: Low dose Low molecular weight heparin or Placebo | Intervention Type: DRUG; Name: Anticoagulation Agents (Edoxaban and/or high dose LMWH); Assigned to Arm(s): Intensive anticoagulation strategy | Intervention Type: DRUG; Name: Low dose Low molecular weight heparin or Placebo; Assigned to Arm(s): Moderate anticoagulation strategy
C: Arm Label: Rivaroxaban 10 mg; Type: ACTIVE_COMPARATOR; Interventions: Drug: Rivaroxaban 10 mg | Arm Label: Best locally standardized care; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: DRUG; Name: Rivaroxaban 10 mg; Assigned to Arm(s): Rivaroxaban 10 mg
D: Arm Label: Test Group; Type: EXPERIMENTAL; Interventions: Drug: Enoxaparin 40Mg/0.4Ml Inj Syringe 0.4Ml | Arm Label: Control Group; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: DRUG; Name: Enoxaparin 40Mg/0.4Ml Inj Syringe 0.4Ml; Assigned to Arm(s): Test Group

Answer: A