Key result
Fondaparinux links to ~88% lower in-hospital VTE risk versus LMWH after major orthopedic surgery.
Why the study?
To compare the real-world efficacy and safety of fondaparinux sodium versus low molecular weight heparin for venous thromboembolism prophylaxis in Chinese patients with major orthopedic surgery or trauma.
Does fondaparinux sodium reduce in-hospital VTE and major bleeding compared to low molecular weight heparin in Chinese patients with major orthopedic surgery or trauma?
Cohort (n=2,429)
No
Does fondaparinux sodium reduce in-hospital VTE and major bleeding compared to low molecular weight heparin in Chinese patients with major orthopedic surgery or trauma?
In a real-world cohort of Chinese patients undergoing major orthopedic surgery or trauma, fondaparinux sodium was associated with a lower incidence of in-hospital VTE and minor bleeding compared to low molecular weight heparin, without increasing major bleeding.
Fondaparinux associated with lower in-hospital VTE without excess major bleeding; leaves open superiority pending randomized trials in Chinese patients.
BACKGROUND: The present real-world study aimed to compare the efficacy and safety between fondaparinux sodium (FPX) and low molecular weight heparin (LMWH) for venous thromboembolism (VTE) prophylaxis in Chinese patients with major orthopedic surgery or trauma. METHODS: A total of 2429 patients, with major orthopedic surgery or trauma, underwent FPX (n = 1177) or LMWH (n = 1252) for VTE prophylaxis and were retrospectively reviewed. Primary outcomes, including in-hospital VTE and in-hospital major bleeding incidences, as well as the secondary outcomes, including in-hospital minor bleeding, in-hospital death, and VTE/bleeding/death within 2 months after discharge, were analyzed. Inverse probability of treatment weighting (IPTW) was conducted. RESULTS: FPX group exhibited lower in-hospital VTE (0.1% vs. 0.8%; P = 0.032, crude OR = 0.11 before IPTW; P = 0.046, weighted OR = 0.12 after IPTW) and in-hospital minor bleeding (17.8% vs. 26.8%; P < 0.001, crude OR = 0.59 before IPTW; P < 0.001, weighted OR = 0.67 after IPTW) compared to LMWH group. Furthermore, no difference of in-hospital major bleeding, in-hospital death, and VTE/bleeding/death within 2 months after discharge was observed between FPX group and LMWH group (all P > 0.05). Further subgroup analyses identified, in specific cluster of patients such as older age, renal function impairment, hypertension and so on, in-hospital VTE was declined in FPX group compared to LMWH group (all P < 0.001). CONCLUSIONS: FPX is probable to exhibit a superior thromboprophylaxis efficacy compared with LMWH in in-hospital patients with major orthopedic surgery or trauma, especially in some special patients such as older age, renal function impairment, hypertension, etc.
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Dong-lin et al. (2022) conducted a cohort in Major orthopedic surgery or trauma (n=2,429). Fondaparinux sodium vs. Low molecular weight heparin was evaluated on In-hospital venous thromboembolism (VTE) (OR 0.12, p=0.046). Fondaparinux sodium significantly reduced the incidence of in-hospital venous thromboembolism compared to low molecular weight heparin (0.1% vs. 0.8%, OR 0.12) in patients with major orthopedic surgery or trauma.
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