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Studies in which heparin products are used to prevent venous thromboembolism (VTE) generally include either twice-daily or thrice-daily regimens, but no trials have been designed to compare dosages of unfractionated heparin (UFH) directly. The last meta-analysis of UFH dosages (JW Gen Med Mar 1 2007) showed that thrice-daily UFH dosing was associated with excess bleeding risk and a modest benefit in preventing pulmonary embolism (PE); however, several randomized controlled trials (RCTs) of VTE prophylaxis that have been conducted since 2007 might shed light on this issue.
In a mixed-treatment–comparison meta-analysis, investigators considered 16 RCTs in which hospitalized medical patients were treated with low-molecular-weight heparin (LMWH)…