title: Oral rivaroxaban for the prevention of symptomatic venous thromboembolism after elective hip and knee replacement.
abstract: 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.
authors.affiliation: University of Gothenburg, Gothenburg, Sweden. b.eriksson@orthop.gu.se
authors.forename: B I
authors.initials: BI
authors.lastname: Eriksson
authors.forename: A K
authors.initials: AK
authors.lastname: Kakkar
authors.forename: A G G
authors.initials: AG
authors.lastname: Turpie
authors.forename: M
authors.initials: M
authors.lastname: Gent
authors.forename: T-J
authors.initials: TJ
authors.lastname: Bandel
authors.forename: M
authors.initials: M
authors.lastname: Homering
authors.forename: F
authors.initials: F
authors.lastname: Misselwitz
authors.forename: M R
authors.initials: MR
authors.lastname: Lassen
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D019643:Arthroplasty, Replacement / Q000009:adverse effects* / Q000401:mortality; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000401:mortality; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000401:mortality; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D017984:Enoxaparin / Q000008:administration & dosage*; D065427:Factor Xa Inhibitors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage*; D000069552:Rivaroxaban; D013876:Thiophenes / Q000008:administration & dosage*; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D065427:Factor Xa Inhibitors; D009025:Morpholines; D013876:Thiophenes; D000069552:Rivaroxaban