WEDNESDAY, June 25 (HealthDay News) -- Extended use of the oral
drug rivaroxaban helps prevent potentially fatal blood clots after
hip replacement surgery, British researchers say.
The risk of venous thromboembolism (VTE) is high after total hip
replacement, and the risk can persist after a patient leaves
hospital. Current guidelines recommend patients receive a
heparin-based preventive drug such as enoxaparin (Lovenox) for a
minimum of 10 days, and up to 35 days, after surgery. However, this
preventive treatment is not used much after patients leave
hospital, according to background information in the study.
The researchers at the London School of Medicine and Dentistry
and the Thrombosis Research Institute compared the new oral
antithrombotic drug rivaroxaban (Xarelto) with enoxaparin in the
treatment of hip replacement patients.
In the randomized, controlled trial, 1,252 patients received 10
milligrams of oral rivaroxaban once daily for 31 to 39 days,
followed by placebo injection for 10 to 14 days, while 1,257
patients received 40 milligram once-daily injections of enoxaparin
for 10 to 14 days, followed by placebo tablets for 31 to 39
days.
The completed analysis of 864 patients in the rivaroxaban group
and 869 patients in the enoxaparin group found that patients in the
enoxaparin group were more than four times as likely to suffer deep
vein thrombosis, nonfatal pulmonary embolism, or die than patients
in the rivaroxaban group -- 9.3 percent versus 2 percent. Both
groups had similar rates of bleeding events during treatment.
"Extended thromboprophylaxis with rivaroxaban was significantly
more effective than short-term enoxaparin plus placebo for the
prevention of venous thromboembolism, including symptomatic events,
in patients undergoing total hip arthroplasty [replacement]," the
researchers concluded.
The study was released online Wednesday by
The Lancet and will be published in an upcoming issue.
"With superior efficacy, no compromise in safety, and a
convenient once-daily regimen, rivaroxaban seems an obvious choice
for simplified thromboprophylaxis after hip or knee arthroplasty
[replacement]," Dr. John Eikelboom and Jeffrey Weitz, of McMaster
University in Hamilton, Ontario, Canada, wrote in an accompanying
editorial.
More information
The American Academy of Orthopaedic Surgeons has more about
total hip replacement.
