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Ann Pharmacother ; 50(4): 270-5, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26783354

ABSTRACT

BACKGROUND: The Regulation of Coagulation in Orthopedic Surgery to Prevent Deep Venous Thrombosis and Pulmonary Embolism (RECORD) 1 to 4 trials compared rivaroxaban 10 mg daily with commonly used doses of enoxaparin and demonstrated similar rates of VTE and bleeding. OBJECTIVE: To evaluate bleeding events between patients who received enoxaparin or rivaroxaban for prevention of venous thromboembolism (VTE) following total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: Retrospective cohort that compared patients undergoing THA and TKA who received enoxaparin (enoxaparin) with those who received rivaroxaban (rivaroxaban) and also with those who received enoxaparin in the RECORD 1 to 4 trials (enoxaparin RECORD). The primary outcome was any postoperative bleeding, defined as a composite of major and clinically relevant nonmajor bleeding based on the definitions in the RECORD 1 to 4 trials. RESULTS: There was a lower rate of any postoperative bleeding (2.2% vs 6.8%, P = 0.004) in patients who received enoxaparin compared with rivaroxaban, and bleeding rates between the enoxaparin group and the enoxaparin RECORD groups were similar (2.2% vs 2.5%, P = 0.085). Major bleeding in the enoxaparin group (0.2%) was not significantly different from that in the rivaroxaban group (1.4%, P = 0.12) or the RECORD group (0.2%, P = 0.93). Clinically relevant nonmajor bleeding was also lower in the enoxaparin group compared with the rivaroxaban group (2.0% vs 5.5%, P = 0.012). CONCLUSIONS: The use of enoxaparin for VTE prophylaxis following THA and TKA was associated with a lower rate of the primary outcome (any postoperative bleeding) compared with the use of rivaroxaban in a similar cohort of patients.


Subject(s)
Arthroplasty, Replacement, Hip/methods , Arthroplasty, Replacement, Knee/methods , Enoxaparin/adverse effects , Rivaroxaban/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Anticoagulants/administration & dosage , Anticoagulants/adverse effects , Enoxaparin/administration & dosage , Female , Humans , Male , Middle Aged , Postoperative Hemorrhage/chemically induced , Pulmonary Embolism/prevention & control , Retrospective Studies , Rivaroxaban/administration & dosage , Venous Thromboembolism/prevention & control , Venous Thrombosis/prevention & control , Young Adult
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