Why the study?
Do oral direct factor Xa inhibitors prevent venous thromboembolism in patients undergoing major orthopedic surgery?
Do oral direct factor Xa inhibitors prevent venous thromboembolism in patients undergoing major orthopedic surgery?
This review summarizes the clinical development of oral direct factor Xa inhibitors for VTE prevention in major orthopedic surgery.
Offers synthesis for VTE prophylaxis choices in orthopedic surgery; leaves open need for updated head-to-head comparisons.
Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is a major cause of morbidity and mortality in patients undergoing major orthopedic surgery, and routine thromboprophylaxis has been the standard of care over the last 20 years. Currently available options for the prevention of VTE in major orthopedic surgery include low-molecular-weight heparins, vitamin K antagonists and, more recently, the synthetic pentasaccharide fondaparinux. Although effective, these drugs have several limitations, and new oral antithrombotics offering predictable, effective and safe anticoagulation are strongly needed. This overview focuses on the most advanced oral direct inhibitors of factor Xa, rivaroxaban, apixaban, LY517717, YM150 and betrixaban. Specifically, the results of phase II and III studies and the designs of ongoing clinical trials in patients undergoing elective hip and knee replacement are reviewed.
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Imberti et al. (2007) studied this question.
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