title: Cost-effectiveness of rivaroxaban after total hip or total knee arthroplasty.
abstract: Venous thromboembolism (VTE) following joint replacement surgery represents an economic as well as a clinical burden; however, the risk of thromboembolic events is greatly reduced by appropriate anticoagulation. Rivaroxaban, a Factor Xa inhibitor currently in phase III development, was compared with the low molecular weight heparin enoxaparin in 4 clinical trials, collectively called the RECORD program (REgulation of Coagulation in Orthopedic Surgery to Prevent Deep Venous Thrombosis and Pulmonary Embolism). In a pooled analysis of data from the RECORD trials, rivaroxaban was superior to enoxaparin regimens in reducing the composite end point of symptomatic venous thromboembolism and all-cause mortality in patients following elective primary total hip or total knee arthroplasty (THA or TKA), with a comparable incidence of major bleeding events. In cost-effectiveness analyses, compared with enoxaparin, rivaroxaban showed the potential to reduce costs associated with the prophylaxis and treatment of thromboembolic events in a post-orthopedic surgery/arthroplasty population.
authors.affiliation: Department of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, CA 90509, USA. lmkwongmd@hotmail.com
authors.forename: Louis M
authors.initials: LM
authors.lastname: Kwong
mesh_terms: D000925:Anticoagulants / Q000191:economics / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003362:Cost-Benefit Analysis; D017984:Enoxaparin / Q000191:economics / Q000627:therapeutic use*; D065427:Factor Xa Inhibitors; D006801:Humans; D009025:Morpholines / Q000191:economics / Q000627:therapeutic use*; D000069552:Rivaroxaban; D013876:Thiophenes / Q000191:economics / Q000627:therapeutic use*; D014481:United States; D054556:Venous Thromboembolism / Q000191:economics / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D065427:Factor Xa Inhibitors; D009025:Morpholines; D013876:Thiophenes; D000069552:Rivaroxaban