LAUSR

With respect to the once versus twice daily injections of low molecular weight heparin, we appreciate the comment on the EFFORT randomised trial, which did actually not compare two different protocols of low molecular weight heparin. This study showed that the percentage of patients who achieved target antiXa levels was higher in the fondaparinux group, a selective inhibitor of factor Xa. However, there were no significant differences in the rates of venous thromboembolism or bleeding. We congratulate Dr Steib for their excellent study, published after our article was written. Their study indicates that 6000 IU 24 1 may be better than 4000 IU once or twice daily and provides an interesting hypothesis explaining their results.