title: Rivaroxaban in preventing venous thromboembolism after arthroplastic surgery in Taiwan.
abstract: Venous thromboembolism (VTE) is one of the severe complications of total hip arthroplasty (THA) and total knee arthroplasty (TKA). The incidence of VTE could be reduced if preventive antithrombotic medicines are used; however, the incidence of bleeding may increase. Rivaroxaban is a factor Xa inhibitor that prevents VTE after THA or TKA. This study is designed to confirm the efficacy and safety of rivaroxaban in Taiwan. This is a retrospective database study based on the data of 6996 patients provided by the Taiwan National Health Insurance Research Database from 2008 to 2012. The data included the number of prescription, the cost of prescription, and case number for patients treated with antithrombotic agents for the prevention or treatment of joint arthroplasty complications (including THA, TKA, partial hip arthroplasty, revision THA and TKA), and the incidence of thrombosis and hemorrhage from year 2008 to 2012. The overall postoperative VTE rate was 0.49%. Compared with other antithrombotic drugs, rivaroxaban and heparin analogs can reduce the percentage of thrombosis. We also found that the expenditure and hospitalization was less in the rivaroxaban group than in the heparin analogs group. Because some benefits of rivaroxaban were found in our study, further cost-effective and drug safety studies are warranted. It is important to consider the cost-effective principle for the use of antithrombotic drugs in preventing thromboembolic complications after total joint arthroplasty.
authors.affiliation: School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yun-Chuan
authors.initials: YC
authors.lastname: Mao
authors.affiliation: Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Hsin Chu, Taiwan.
authors.forename: Shih-Tse
authors.initials: ST
authors.lastname: Chen
authors.affiliation: Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Orthopaedic Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Chung-Hwan
authors.initials: CH
authors.lastname: Chen
authors.affiliation: School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Kun-Pin
authors.initials: KP
authors.lastname: Hsieh
authors.affiliation: School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: gakiho@kmu.edu.tw.
authors.forename: Kim-Hong
authors.initials: KH
authors.lastname: Gan
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000191:economics; D005102:Health Expenditures; D006760:Hospitalization; D006801:Humans; D010351:Patient Discharge / Q000191:economics; D000069552:Rivaroxaban / Q000191:economics / Q000627:therapeutic use*; D013624:Taiwan; D054556:Venous Thromboembolism / Q000188:drug therapy / Q000191:economics / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000069552:Rivaroxaban
keywords: Antithrombotic agents; Deep vein thrombosis; Rivaroxaban; Total hip arthroplasty; Total knee arthroplasty