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Oral Drug for Post-Knee Surgery Thromboprophylaxis Assessed

Oral drug apixaban found more effective than enoxaparin; does not increase risk of bleeding

FRIDAY, March 5 (HealthDay News) -- Patients who undergo knee replacement surgery can be given the oral medication apixaban for thromboprophylaxis instead of enoxaparin, and it is effective and confers no additional risk of bleeding, according to a study in the March 6 issue of The Lancet.

Michael Rud Lassen, M.D., of the University of Copenhagen in Horsholm, Denmark, and colleagues conducted a study of 3,057 patients undergoing elective unilateral or bilateral total knee replacement, of whom 1,528 were randomized to receive 2.5 mg of oral apixaban twice a day starting 12 to 24 hours after wound closure, while 1,529 received 40 mg of subcutaneous enoxaparin once a day starting 12 hours before surgery.

Of the 1,973 patients eligible for analysis after 10 to 14 days' treatment, 147 (15 percent) of the 976 apixaban patients and 243 (24 percent) of the 997 enoxaparin patients reached the primary outcome, which was a composite of deep vein thrombosis, non-fatal pulmonary embolism and all-cause mortality, the researchers found.

"Apixaban 2.5 mg twice daily, starting on the morning after total knee replacement, offers a convenient and more effective orally administered alternative to 40 mg per day enoxaparin, without increased bleeding," the authors write.

The study was funded by Bristol-Myers Squibb and Pfizer, and several study authors have financial ties to these and other pharmaceutical companies.

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