Why the study?
Does sequential subcutaneous melagatran and oral ximelagatran prevent venous thromboembolism in hospital in-patients undergoing orthopaedic surgery compared to LMWHs?
Does sequential subcutaneous melagatran and oral ximelagatran prevent venous thromboembolism in hospital in-patients undergoing orthopaedic surgery compared to LMWHs?
Sequential melagatran and ximelagatran provide an effective, safe, and convenient alternative to LMWHs and warfarin for venous thromboprophylaxis in orthopaedic surgery.
Answers are grounded in this paper and cite their sources.
May support convenient oral VTE prophylaxis post-orthopedic surgery; hypothesis-generating and should not yet change practice.
Venous thromboembolism is a common and potentially fatal complication among hospital in-patients, particularly those undergoing orthopaedic surgery. Current prophylactic strategies utilise low molecular weight heparins (LMWHs) and warfarin. However, painful subcutaneous injections for LMWHs and delays in achieving target anticoagulation for warfarin pose significant problems clinically. The Melagatran for THRombin inhibition in Orthopaedic surgery (METHRO) trial represents a landmark step in the sequential combination of subcutaneous and oral anticoagulation with melagatran and ximelagatran, respectively, for surgical venous thromboprophylaxis. These agents have proven to be as effective and safe as LMWHs. Furthermore, with no need for dosage adjustment or therapeutic drug monitoring there is emerging evidence that ximelagatran may replace warfarin as the anticoagulant of choice.
No takes yet. Share an insight, caveat, or question.
Hamaad et al. (2003) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: