Key result
A mixed regimen of fondaparinux (2.5 mg for 3 days followed by 1.5 mg for 7 days) significantly reduced the incidence of deep venous thrombosis compared to control at day 14.
Why the study?
Does fondaparinux prevent deep venous thrombosis in Japanese patients undergoing cemented total hip replacement?
Does fondaparinux prevent deep venous thrombosis in Japanese patients undergoing cemented total hip replacement?
A mixed dosing regimen of fondaparinux (2.5 mg for 3 days followed by 1.5 mg for 7 days) is effective for preventing DVT after cemented total hip replacement in Japanese patients.
Supports adjusted fondaparinux dosing for DVT prevention in Japanese cemented THA patients; hypothesis-generating and requires RCTs before practice change.
The aim of this study was to estimate the effective administration procedure of fondaparinux for prevention of venous thromboembolism after cemented total hip replacement (THR) in Japanese patients. The study included 471 Japanese patients. The dose regimens were 2.5 mg daily for 14 days (2.5 mg/14 day group) or 10 days (2.5 mg/10 day group), 1.5 mg daily for 10 days (1.5 mg group), 2.5 mg daily for the first 3 postoperative days and 1.5 mg daily for the subsequent 7 days (Mixed group), and no administration of fondaparinux (Control group). Deep venous thrombosis (DVT) was diagnosed by ultrasonography on postoperative day 3 or 4 and day 14. The 2.5 mg/14 day, 2.5 mg/10 day and Mixed groups were regarded as one group in the assessment on postoperative day 3 or 4, and denoted as the 2.5 mg group. The incidence of DVT on postoperative day 3 or 4 in the 2.5 mg group was significantly lower than that in the Control and 1.5 mg groups. On postoperative day 14, the incidence of DVT in the 1.5 mg and Mixed groups was significantly lower than that in the Control group in both the intention-to-treat and per-protocol analyses. The incidence in the 2.5 mg/10 day and 2.5 mg/14 day groups was significantly lower than that in the Control group in only the per-protocol analysis. The results suggest that the administration protocol of the Mixed group is effective in preventing DVT in Japanese patients undergoing cemented THR.
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Kawaji et al. (2011) studied Deep venous thrombosis after cemented total hip replacement (n=471). Fondaparinux vs. No administration of fondaparinux (Control group) was evaluated on Deep venous thrombosis (DVT) diagnosed by ultrasonography on postoperative day 3 or 4 and day 14. A mixed regimen of fondaparinux (2.5 mg for 3 days followed by 1.5 mg for 7 days) significantly reduced the incidence of deep venous thrombosis compared to control at day 14.
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