Apixaban versus Enoxaparin for Thromboprophylaxis in Medically Ill Patients

Rivaroxaban for Thromboprophylaxis in Acutely Ill Medical Patients

“…However, there was no reduction with rivaroxaban in the rate of death from any cause, and the incidence was similar in the two groups -findings that were consistent with those in other studies. 11,12 The prespecified analysis of net clinical benefit or harm did not show a benefit with rivaroxaban at either day 10 or day 35.…”

“…9 The results of the current study support those from other studies that showed the efficacy of extended thromboprophylaxis 11 but also the increased risk of bleeding. 11,12 One limitation of our trial was the inclusion of asymptomatic proximal deep-vein thrombosis, as detected on ultrasonography, as part of the primary efficacy outcome. Ultrasonography is not performed routinely in medical patients.…”

“…Ultrasonography is not performed routinely in medical patients. 12 The use of this test may have influenced the trial in two ways. First, the performance of ultrasonography at day 10 may have influenced the subsequent natural history of the disease because it may have resulted in the treatment of asymptomatic disease.…”

“…9 There is some evidence that the risk of venous thromboembolism in acutely ill medical patients persists after hospital discharge 10 ; however, no studies have supported the routine use of extended thromboprophylaxis. 11,12 Rivaroxaban is an oral, direct factor Xa inhibitor that is used for the prevention of venous thromboembolism after elective hip-replacement or knee-replacement surgery in adults. The Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin (MAGELLAN) was designed to assess the efficacy and safety of rivaroxaban administered for 35 days, as compared with enoxaparin administered for 10 days and followed by placebo, in a heterogeneous population of patients 40 years of age or older with reduced mobility and an acute medical illness requiring hospitalization.…”

Resumen de los ensayos clínicos presentados en las Sesiones Científicas Anuales de la American Heart Association (Orlando, Estados Unidos, 12-16 de noviembre de 2011)

“…MISCELÁNEA ADOPT: profilaxis anticoagulante extendida en pacientes hospitalizados por causa médica 27 Presentado por: Samuel Z. Goldhaber, Boston, Massachusetts, Estados Unidos.…”