Analysis of anticoagulant use in patients with recurrent spontaneous abortion across nine Chinese cities (2016-2021)
Objective: In this study, we aimed to identify trends in anticoagulant usage among patients with recurrent spontaneous abortion (RSA), assess the appropriateness of these prescriptions, and provide recommendations for future clinical practice. Methods: We retrospectively analyzed outpatient prescrip...
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Published in | Reproductive and developmental medicine Vol. 9; no. 2; pp. 100 - 107 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
Hagerstown, MD
Lippincott Williams & Wilkins
01.06.2025
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Subjects | |
Online Access | Get full text |
ISSN | 2096-2924 2589-8728 |
DOI | 10.1097/RD9.0000000000000102 |
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Abstract | Objective:
In this study, we aimed to identify trends in anticoagulant usage among patients with recurrent spontaneous abortion (RSA), assess the appropriateness of these prescriptions, and provide recommendations for future clinical practice.
Methods:
We retrospectively analyzed outpatient prescription data for patients with RSA from nine Chinese cities-Beijing, Chengdu, Guangzhou, Harbin, Hangzhou, Shanghai, Shenyang, Tianjin, and Zhengzhou-over the period 2016 to 2021.
Results:
A total of 10,293 outpatient prescriptions were reviewed. The number of prescriptions increased annually until peaking in 2019, after which a gradual decline was observed. From 2019 to 2021, enoxaparin was the most frequently prescribed anticoagulant. Among the eight anticoagulants analyzed, enoxaparin had the highest total prescription volume and defined daily doses (DDDs), followed by dalteparin, nadroparin, and fondaparinux. The proportion of fondaparinux prescriptions rose annually, and while its defined daily cost (DDC) was consistently the highest, there was a downward trend in value. The economic benefits of most anticoagulants were aligned with their social benefits. Although the percentage of prescriptions with inappropriate indications decreased each year, it remained high at 69%.
Conclusion:
Enoxaparin emerged as the predominant anticoagulant for RSA treatment in the nine cities studied. Fondaparinux usage increased in clinical practice, with a decreasing trend in DDC values. The alignment of economic and societal benefits indicates good cost-effectiveness. However, there remains a need to further improve the appropriateness of prescription indications. |
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AbstractList | Objective:
In this study, we aimed to identify trends in anticoagulant usage among patients with recurrent spontaneous abortion (RSA), assess the appropriateness of these prescriptions, and provide recommendations for future clinical practice.
Methods:
We retrospectively analyzed outpatient prescription data for patients with RSA from nine Chinese cities-Beijing, Chengdu, Guangzhou, Harbin, Hangzhou, Shanghai, Shenyang, Tianjin, and Zhengzhou-over the period 2016 to 2021.
Results:
A total of 10,293 outpatient prescriptions were reviewed. The number of prescriptions increased annually until peaking in 2019, after which a gradual decline was observed. From 2019 to 2021, enoxaparin was the most frequently prescribed anticoagulant. Among the eight anticoagulants analyzed, enoxaparin had the highest total prescription volume and defined daily doses (DDDs), followed by dalteparin, nadroparin, and fondaparinux. The proportion of fondaparinux prescriptions rose annually, and while its defined daily cost (DDC) was consistently the highest, there was a downward trend in value. The economic benefits of most anticoagulants were aligned with their social benefits. Although the percentage of prescriptions with inappropriate indications decreased each year, it remained high at 69%.
Conclusion:
Enoxaparin emerged as the predominant anticoagulant for RSA treatment in the nine cities studied. Fondaparinux usage increased in clinical practice, with a decreasing trend in DDC values. The alignment of economic and societal benefits indicates good cost-effectiveness. However, there remains a need to further improve the appropriateness of prescription indications. |
Author | Pang, Xiao-Ying Wang, Xian-Li |
Author_xml | – sequence: 1 givenname: Xiao-Ying surname: Pang fullname: Pang, Xiao-Ying organization: Department of Pharmacy, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China – sequence: 2 givenname: Xian-Li surname: Wang fullname: Wang, Xian-Li email: 1691@fckyy.org.cn organization: Department of Pharmacy, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China |
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Cites_doi | 10.1186/s12884-021-04161-1 10.1046/j.1365-2141.2003.04196.x 10.3389/fendo.2021.717630 10.1111/cod.12764 10.1007/s00261-021-03245-y 10.1038/s41572-020-00228-z 10.1503/cmaj.181124 10.1055/s-0038-1673402 10.1016/j.ejogrb.2021.10.036 10.1177/10760296211014575 10.1080/01443615.2019.1576600 10.1111/1756-185X.13057 10.1016/bs.pmbts.2019.02.003 10.1136/bmj.l869 10.1185/03007995.2013.837818 10.1055/a-1030-4546 |
ContentType | Journal Article |
Copyright | Copyright © 2024 Reproductive and Developmental Medicine, Published by Wolters Kluwer Health, Inc. |
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Keywords | Enoxaparin Anticoagulants Recurrent spontaneous abortion Fondaparinux |
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Notes | Received: 19 March 2024 Accepted: 27 June 2024 Edited by: Yong-Qing Zhu How to cite this article: Pang XY, Wang XL. Analysis of anticoagulant use in patients with recurrent spontaneous abortion across nine Chinese cities (2016-2021). Reprod Dev Med 2025;9(2):100-107. doi: 10.1097/RD9.0000000000000102 *Corresponding to: Xian-Li Wang, Department of Pharmacy, Obstetrics and Gynecology Hospital of Fudan University, 128 Shenyang Road, Shanghai 200011, China. E-mail: 1691@fckyy.org.cn |
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PublicationPlace | Hagerstown, MD |
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PublicationTitle | Reproductive and developmental medicine |
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Influence of socioeconomic and geographical variables on disease phenotype and activity in Chinese patients with SLE. publication-title: Int J Rheum Dis doi: 10.1111/1756-185X.13057 – volume: 41 start-page: 861 issue: 10 year: 2021 ident: R23-20250623 article-title: Chinese experts consensus on the diagnosis and treatment of recurrent spontaneous abortion with prethrombotic state. publication-title: Chin J Reprod Contracep – volume: 163 start-page: 21 year: 2019 ident: R18-20250623 article-title: Low molecular weight heparins and their clinical applications. publication-title: Prog Mol Biol Transl Sci doi: 10.1016/bs.pmbts.2019.02.003 – volume: 364 start-page: l869 year: 2019 ident: R17-20250623 article-title: Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. publication-title: BMJ doi: 10.1136/bmj.l869 – volume: 30 start-page: 367 issue: 3 year: 2014 ident: R20-20250623 article-title: Comparison of the efficacy and safety of low molecular weight heparins for venous thromboembolism prophylaxis in medically ill patients. publication-title: Curr Med Res Opin doi: 10.1185/03007995.2013.837818 – volume: 80 start-page: 48 issue: 1 year: 2020 ident: R10-20250623 article-title: Prophylaxis and therapy of venous thrombotic events (VTE) in pregnancy and the postpartum period. publication-title: Geburtshilfe Frauenheilkd doi: 10.1055/a-1030-4546 – volume: 57 start-page: 653 issue: 9 year: 2022 ident: R1-20250623 article-title: Chinese expert consensus on diagnosis and management of recurrent spontaneous abortion. publication-title: Chin J Obstet Gynecol |
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