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Apixaban May Beat Enoxaparin After Hip Replacement

Oral agent associated with lower thromboembolism risk without increased bleeding

WEDNESDAY, Dec. 22 (HealthDay News) -- In patients undergoing hip replacement, thromboprophylaxis with apixaban, an orally active, specific factor Xa inhibitor, is associated with lower rates of venous thromboembolism than enoxaparin, according to a study published in the Dec. 23 issue of the New England Journal of Medicine.

Michael Rud Lassen, M.D., of the University of Copenhagen in Hørsholm, Denmark, and colleagues randomly assigned 5,407 total hip replacement patients to oral apixaban or subcutaneous enoxaparin to test the efficacy of apixaban as a thromboprophylaxis.

Of the 1,949 patients in the apixaban group and the 1,917 patients in the enoxaparin group that the researchers were able to evaluate, the primary efficacy outcome (a composite of asymptomatic or symptomatic deep-vein thrombosis, nonfatal pulmonary embolism, or death from any cause) occurred in 27 (1.4 percent) of the apixaban recipients and 74 (3.9 percent) of the enoxaparin recipients. Major and clinically-relevant nonmajor bleeding occurred in 4.8 percent of apixaban recipients and 5 percent of enoxaparin recipients.

"Among patients undergoing hip replacement, thromboprophylaxis with apixaban, as compared with enoxaparin, was associated with lower rates of venous thromboembolism, without increased bleeding," the authors write.

The study was funded by Bristol-Myers Squibb and Pfizer; several authors disclosed financial relationships with these and other pharmaceutical and/or medical device companies.

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