エノキサパリンの臨床開発の舞台裏：ベンチからベッドサイドへ

The path to the development of enoxaparin (Lovenox/Clexane), one of the most widely used low molecular weight heparins (LMWH) worldwide, was far from smooth. This narrative review, presented from the personal perspective of the senior author who lived this journey, describes the pivotal research conducted at McMaster University in Canada that transformed enoxaparin from a promising laboratory compound into a cornerstone of prevention and treatment of thrombosis. The story begins in the late 1970s with the observation that a LMWH, produced through controlled depolymerization, exhibited comparable antithrombotic efficacy to unfractionated heparin with a reduced risk of bleeding in animal models. It ends in the 1990s with the successful evaluation in clinical trials and the regulatory approval of enoxaparin for the prevention of deep vein thrombosis after orthopedic surgery.