Options for prevention and correction of a risk for thrombotic events related to hormonal contraception

Pekarev O.G., Madonov P.G.

1) Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) Novosibirsk State Medical University, Ministry of Health of Russia, Novosibirsk, Russia
The use of combined oral contraceptives (COCs) carries a risk of thrombotic events and phlebopathies. The most common clinical presentation of COC-induced thrombosis is venous thromboembolism of the leg deep veins or pulmonary vessels. Traditional anticoagulants are unsuitable for the routine prevention of COC-induced venous thromboembolic (VTE) events, since they require long-term systematic use. There is a group of proteolytic enzymes, such as subtilisins, that have a pronounced fibrinolytic effect. These enzymes are unique in that they dissolve only denatured or polymerized proteins. For example, subtilisins have no action on fibrinogen, but dissolve cross-linked fibrin. This fibrinolytic action of subtilisins is direct without involving the fibrinolytic system in physiological processes is an important circumstance. Subtilisins have been used to design Trombovazim that has a thrombolytic effect and has been registered for the treatment of venous insufficiency. Several clinical trials have been conducted to prove the high clinical efficacy and safety of Trombovazim used as an oral thrombolytic drug and for the treatment of phlebopathies. To date, the pharmaceutical markets in Russia and other countries lack a similar drug that, when administered orally, is able to dissolve blood clots on its own.
Conclusion. The use of Thrombovazim in gynecology is a new method to treat and prevent COC-induced VTE events and phlebopathies.

Keywords

combined oral contraceptives
thromboses
phlebopathies
subtilisins
Trombovazim

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Received 21.09.2020

Accepted 17.12.2020

About the Authors

Oleg G. Pekarev, MD, professor, Deputy Director of the Institute of Obstetrics, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. Tel.: +7(906)996-49-88. E-mail: o_pekarev@oparina4.ru. ORCID: 0000-0001-7122-6830. 117997, Russia, Moscow, Oparina str., 4.
Pavel G. Madonov, MD, professor, Head of the Department of Pharmacology, Clinical Pharmacology and Evidence-Based Medicine, Novosibirsk State Medical University, Ministry of Health of Russia. Tel.: +7(913)379-83-03. E-mail: pmadonov@yandex.ru. ORCID: 0000-0001-7122-6830.630091, Russia, Novosibirsk, Krasny Ave., 52.

For citation: Pekarev O.G., Madonov P.G. Options for prevention and correction of a risk for thrombotic events related to hormonal contraception.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 1: 44-50 (in Russian)
https://dx.doi.org/10.18565/aig.2021.1.44-50

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