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Rivaroxaban Found Superior to Enoxaparin

Three studies show significantly lower rates of adverse events after total knee or hip arthroplasty

WEDNESDAY, June 25 (HealthDay News) -- In patients undergoing either total hip replacement or total knee replacement, thromboprophylaxis with rivaroxaban is significantly more effective at preventing adverse events than thromboprophylaxis with enoxaparin, according to two studies published in the June 26 issue of the New England Journal of Medicine and one study published online June 25 in The Lancet.

In the first NEJM study, Bengt I. Eriksson, M.D., of Aarhus University Hospital in Aarhus, Denmark, and colleagues randomly assigned 4,541 hip arthroplasty patients to receive either rivaroxaban or enoxaparin. They found that rivaroxaban was associated with a significantly lower incidence of deep-vein thrombosis (DVT), non-fatal pulmonary embolism (PE) and death from any cause at 36 days post-surgery (1.1 percent versus 3.7 percent).

In the second NEJM study, Michael R. Lassen, M.D., of Nordsjaellands Hospital in Horsholm, Denmark, and colleagues randomly assigned 2,531 knee arthroplasty patients to receive either rivaroxaban or enoxaparin. They found that rivaroxaban was associated with a significantly lower incidence of DVT, non-fatal PE and death from any cause at 13 to 17 days post-surgery (9.6 percent versus 18.9 percent).

In The Lancet study, Ajay K. Kakkar, M.D., of the London School of Medicine and Dentistry in London, U.K., and colleagues randomly assigned 2,509 hip arthroplasty patients to receive either rivaroxaban or enoxaparin. They found that rivaroxaban was associated with a significantly lower incidence of DVT, non-fatal PE and death from any cause up to days 30 to 42 post-surgery (2 percent versus 9.3 percent). "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," Kakkar's team concludes.

All three studies were supported by Bayer HealthCare and Johnson & Johnson. Several authors from the studies and the editorial report a financial relationship with the pharmaceutical industry.

Abstract - Eriksson
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Abstract - Lassen
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Abstract - Kakkar
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