Apixaban Versus Enoxaparin in Elective Major Orthopedic Surgery

Maniscalco, Pietro; Caforio, Marco; Imberti, Davide; Porcellini, Giuseppe; Benedetti, Raffaella

doi:10.1177/1076029614546328

Cited by 6 publications

(6 citation statements)

References 15 publications

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“…When compared individually for TKA and THA, apixaban was found to be associated with significantly lower risk of having an adverse event in the THA group while this was not significant in the TKA group. This finding is consistent with previous trials and meta‐analyses, which have showed that either apixaban is safer than enoxaparin or there is no significant difference between the 2 when compared for safety profiles 7–13,22–25 …”

Section: Discussionsupporting

confidence: 91%

“…This finding is consistent with previous trials and meta-analyses, which have showed that either apixaban is safer than enoxaparin or there is no significant difference between the 2 when compared for safety profiles. [7][8][9][10][11][12][13][22][23][24][25] This study shows no significant difference between incidences of VTE with the sex of patient similar to conclusion drawn by Schiff et al, although age showed a significant correlation with VTE irrespective of the group, similar to data reported earlier. 26 No study has previously reported the comparison of enoxaparin and apixaban with functional outcome of an arthroplasty patient.…”

Section: Safety Outcomesupporting

confidence: 92%

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Apixaban or enoxaparin: Which is better for thromboprophylaxis after total hip and total knee arthroplasty in Indian patients?

Kunal

Banerjee

Garg

et al. 2021

Brit J Clinical Pharma

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Both apixaban and enoxaparin are Food and Drug Administration‐approved standard therapy for prophylaxis of deep‐vein thrombosis; however, the superiority of one over the other is still controversial. With an objective to observe efficacy and safety outcomes of apixaban and enoxaparin in patients undergoing total hip (THA) and knee (TKA) arthroplasty, 96 patients undergoing THA/TKA (October 2018 to August 2019) were randomly allocated into 2 groups; (n = 48) apixaban; and (n = 48) enoxaparin. Efficacy outcomes and safety outcomes were recorded at 2 and 5 weeks post‐TKA/THA. Follow‐up functional scoring was done at 6 months postoperatively. Apixaban and enoxaparin were found to be equally efficacious in preventing venous thromboembolism; however, apixaban had a better safety profile. The apixaban group had nonsignificant higher tendency for wound discharge, atrial fibrillation and transient ischaemic attack. Enoxaparin had nonsignificant greater tendency for bleeding, wound dehiscence and pulmonary complications. Apixaban is a safe alternative to conventionally used enoxaparin for chemoprophylaxis in patients undergoing THA or TKA.

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Section: Discussionsupporting

confidence: 91%

Section: Safety Outcomesupporting

confidence: 92%

Apixaban or enoxaparin: Which is better for thromboprophylaxis after total hip and total knee arthroplasty in Indian patients?

Kunal

Banerjee

Garg

et al. 2021

Brit J Clinical Pharma

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“…14 Despite these recommendations, recent studies show the superiority of rivaroxaban and other NOACs in preventing VTE, without increasing major bleeding or all-cause mortality, compared with enoxaparin. [16][17][18][19] Furthermore, even more recently, the ICM-VTE: Hip & Knee recommendations state aspirin as the most effective and safest choice. 15 In our analysis, we found out that women compose the vast majority of the patients undergoing TKR (77.66%) in this hospital (Table 1), so one might point out that the incidence of knee osteoarthritis might be bigger in women.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effective VTE prophylaxis with enoxaparin after elective THR or TKR: a retrospective observational study

Nóbrega Catelas,

Cordeiro,

Loureiro

et al. 2023

Porto Biomedical Journal

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Background: Orthopedic patients are at the highest risk for venous thromboembolism (VTE). Nowadays, with VTE prophylaxis as a routine in patients undergoing total hip replacement (THR) and total knee replacement (TKR), fatal pulmonary embolism (PE) is rare and the rates of symptomatic VTE within 3 months dropped to 1.3%–10%, compared with the rates of 50%–70% before VTE prophylaxis implementation. In this study, we aim to evaluate the VTE prophylaxis and incidence in patients who underwent THR and TKR in Centro Hospitalar Universitário de Santo António (CHUdSA). Methods: We included 483 patients who underwent elective THR or TKR in CHUdSA from March 2019 to February 2020 and who were under enoxaparin as a VTE prophylaxis drug. All data related to prescribed enoxaparin were collected from the nationwide common electronic drug prescription system (PEM). Results: Of the 483 eligible patients, 192 (39.75%) underwent elective THR and 291 (60.25%) underwent TKR. Enoxaparin was prescribed for 31.86 ± 5.98 and 30.28 ± 5.97 days, on average, for the THR and TKR groups, respectively (P = .005). Patients completed, on average, 29.38 ± 8.12 days and 28.20 ± 7.32 days of VTE prophylaxis with enoxaparin in the THR and TKR groups, respectively (P = .098). The incidence of VTE was approximately 3.13% and 0.69% in the THR and TKR groups, respectively (P = .064). Conclusion: In CHUdSA, we usually prescribe enoxaparin 40 mg once daily for up to 35 days for VTE prophylaxis after THR or TKR. High therapeutic compliance rates resulted in very few events.

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“…Generally speaking, the major orthopedic surgery can result in the high risk for venous thromboembolism, which can potentially lead to various chronic complications. Therefore, the DVT prophylaxis has been the conventional care for patients who ever undergo major orthopedic surgery in clinical practice [ 25 , 26 ]. At present, a variety of treatment to prevent DVT are necessary and available in clinical practice, and the two primary approaches are pharmacological strategy and mechanical devices, such as antiplatelet, anticoagulant, IPCD, graduated compression stockings, and plantar vein pumps, etc.…”

Section: Discussionmentioning

confidence: 99%

Semiautomatic intermittent pneumatic compression device applied to deep vein thrombosis in major orthopedic surgery

Wei

Bao

Li³

et al. 2018

BioMed Eng OnLine

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ObjectiveTo investigate the effect of additional semiautomatic intermittent pneumatic compression device (IPCD) in the prevention of deep vein thrombosis (DVT) of lower extremity in these patients undergoing major orthopedic surgery, when compared with the conventional graduated compression stockings alone.MethodsThe data of 112 patients undergoing major orthopedic surgery were retrospectively analyzed. 51 patients who ever received IPCD and graduated compression stockings during major orthopedic surgery were taken as the experimental group, and 61 patients who only received the conventional graduated compression stockings during surgery were taken as the observation group. The Doppler sonography was utilized to detect the presence of DVT and pulmonary embolism pre- and postoperatively. Besides, the mean and peak velocity of blood flow in femoral vein were recorded before and after surgery. And then, the comparisons between the two groups were made, respectively.ResultsWhen compared with the conventional graduated compression stockings alone, the intraoperative application of IPCD and stockings contributed the significant reduction of DVT (3.92%, 2/51 versus 9.84%, 6/61, X2 = 5.632, P = 0.034). In terms of the mean and peak velocity of blood flow in femoral vein, the postoperative difference was higher in the observation group than those in the control group (149.56 ± 26.35 versus 130.15 ± 22.56 mm/s, P < 0.05). With respect to perioperative blood loss, the difference between the two groups was statistically significant (800.5 ± 320.7 versus 950.1 ± 305.9 ml, P = 0.031).ConclusionsIntraoperative application of IPCD could promote blood circulation of lower limbs, and significantly decrease the incidence of potentially fatal DVT in patients undergoing major orthopedic surgery, when compared with the conventional graduated compression stockings.

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Apixaban Versus Enoxaparin in Elective Major Orthopedic Surgery

Cited by 6 publications

References 15 publications

Apixaban or enoxaparin: Which is better for thromboprophylaxis after total hip and total knee arthroplasty in Indian patients?

Apixaban or enoxaparin: Which is better for thromboprophylaxis after total hip and total knee arthroplasty in Indian patients?

Effective VTE prophylaxis with enoxaparin after elective THR or TKR: a retrospective observational study

Semiautomatic intermittent pneumatic compression device applied to deep vein thrombosis in major orthopedic surgery

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