Oral rivaroxaban for the prevention of symptomatic venous thromboembolism after elective hip and knee replacement

• A once-daily dose of rivaroxaban 10 mg, an oral, direct Factor Xa inhibitor, was compared with enoxaparin 40 mg subcutaneously once daily for prevention of venous thromboembolism in three studies of patients undergoing elective hip and knee replacement (RECORD programme). A pooled analysis of data from these studies (n = 9581) showed that rivaroxaban was more effective than enoxaparin in reducing the incidence of the composite of symptomatic venous thromboembolism and all-cause mortality at two weeks (0.4% vs 0.8%, respectively, odds ratio 0.44; 95% confidence interval 0.23 to 0.79; p = 0.005), and at the end of the planned medication period (0.5% vs 1.3%, respectively; odds ratio 0.38; 95% confidence interval 0.22 to 0.62; p < 0.001). The rate of major bleeding was similar at two weeks (0.2% for both) and at the end of the planned medication period (0.3% vs 0.2%). Rivaroxaban started six to eight hours after surgery was more effective than enoxaparin started the previous evening in preventing symptomatic venous thromboembolism and all-cause mortality, without increasing major bleeding.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Keyword

Administration

Oral

Adolescent

Adult

Aged

Aged

80 and over

Anticoagulants/*administration & dosage

Arthroplasty

Replacement/*adverse effects/mortality

Arthroplasty

Replacement

Hip/adverse effects/mortality

Arthroplasty

Replacement

Knee/adverse effects/mortality

Double-Blind Method

Drug Administration Schedule

Enoxaparin/*administration & dosage

Factor Xa/*antagonists & inhibitors

Female

Humans

Male

Middle Aged

Morpholines/*administration & dosage

Thiophenes/*administration & dosage

Treatment Outcome

Venous Thromboembolism/*prevention & control

Young Adult

Publication and Content Type

ref (subject category)

art (subject category)