Efficacy of delayed thromboprophylaxis with dabigatran: Pooled analysis.

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Eriksson, Bengt I.,1946Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics (author)

Efficacy of delayed thromboprophylaxis with dabigatran: Pooled analysis.

Article/chapterEnglish2012

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Elsevier BV,2012

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LIBRIS-ID:oai:gup.ub.gu.se/166356
https://gup.ub.gu.se/publication/166356URI
https://doi.org/10.1016/j.thromres.2012.08.315DOI

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Language:English

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Subject category:art swepub-publicationtype

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INTRODUCTION: Oral thromboprophylaxis with dabigatran etexilate should be initiated as a half dose 1 to 4h after major orthopaedic surgery. However, a delay in dosing could occur for clinical or logistical reasons. A post hoc analysis was carried out to determine if patients with delayed dosing received adequate anticoagulation. PATIENTS AND METHODS: The RE-MODEL™ and RE-NOVATE® trials compared 220mg and 150mg dabigatran etexilate with 40mg enoxaparin. Pooled data for major venous thromboembolism (VTE) and VTE-related mortality (efficacy outcome) and major bleeding events (MBE), MBE/clinically relevant bleeding events, and all bleeding events (safety outcomes) were analysed. Results in patients with dosing delayed more than 4h postsurgery were compared with those of patients without a delay. RESULTS: Onset of treatment was delayed in 724 (13.3%) of 5425 patients. Efficacy of 220mg dabigatran etexilate was similar in patients without delayed dosing, patients with a delay and patients with a delay until the day after surgery. Rates of efficacy outcome were higher in patients on 150mg dabigatran etexilate, but more than 80% of these patients were undertreated based on age or renal clearance status. Some differences in bleeding events were seen among patient groups by treatment arm. CONCLUSION: Dabigatran etexilate thromboprophylaxis should be initiated 1 to 4h postsurgery. Results from our post-hoc analysis indicate that no loss of efficacy appears to occur if initiation of dabigatran etexilate 220mg needs to be delayed.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Ortopedi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Orthopaedics hsv//eng

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Dahl, Ola E (author)
Rosencher, Nadia (author)
Clemens, Andreas (author)
Hantel, Stefan (author)
Kurth, Andreas A (author)
Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för ortopedi (creator_code:org_t)

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In:Thrombosis research: Elsevier BV130:6, s. 871-8761879-24720049-3848

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Orthopaedics

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