title: Apixaban versus enoxaparin in elective major orthopedic surgery: a clinical review.
abstract: Despite current guidelines recommendations about anticoagulant prophylaxis, many studies have shown an high venous thromboembolism (VTE) incidence in patients undergoing total hip and knee arthroplasty. A number of anticoagulants are currently available, but they have some limitations that affect their applicability and consequently their effectiveness. Several new oral anticoagulants (NOACs) have been developed in an attempt to overcome these limitations. Apixaban is a NOAC that selectively inhibits the coagulation factor Xa; it is approved for the prevention of VTE after total hip replacement and total knee replacement surgery. This review examines the results of main trials designed to test efficacy and safety of apixaban in major elective orthopedic surgery.
authors.affiliation: Department of Orthopaedics and Traumatology, Piacenza Hospital, Piacenza, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Maniscalco
authors.affiliation: Department of Orthopaedics and Traumatology, Piacenza Hospital, Piacenza, Italy m.caforio@ausl.pc.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Caforio
authors.affiliation: Department of Internal Medicine, Piacenza Hospital, Piacenza, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Imberti
authors.affiliation: Department of Orthopaedic Shoulder Surgery, Cattolica, Rimini, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Porcellini
authors.affiliation: Department of Internal Medicine, Piacenza Hospital, Piacenza, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Benedetti
mesh_terms: D000284:Administration, Oral; D019644:Arthroplasty, Replacement, Hip; D017984:Enoxaparin / Q000009:adverse effects / Q000627:therapeutic use*; D065427:Factor Xa Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D011720:Pyrazoles / Q000009:adverse effects / Q000627:therapeutic use*; D011728:Pyridones / Q000009:adverse effects / Q000627:therapeutic use*; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D017984:Enoxaparin; D065427:Factor Xa Inhibitors; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban
keywords: apixaban; hip replacement; knee replacement; major orthopedic surgery; phase 3 clinical trials; review; venous thromboembolism