[Dabigatran and rivaroxaban as thrombophylaxis after major orthopedic surgery]

Pichon Riviere A, Augustovski F, Garcia Marti S, Alcaraz A, Glujovsky D, Lopez A, Rey-Ares L, Bardach A, Lopez A, Alcaraz A, Valanzasca P, Regueiro A, Rey-Ares, L, Beratarrechea A, Elorriaga N
Record ID 32011000980
Authors' objectives:

To assess the available evidence on the efficacy, safety and other issues related with coverage policies on the use of dabigatran and rivaroxaban as thrombophylaxis after a major orthopedic surgery.

Authors' recomendations: The assessed studies showed that both dabigatran and rivaroxaban have a benefit similar to that of enoxaparin.As regards dabigatran, there are differences depending on which the enoxaparin, used as comparator, regime is. Dabigatran proved to be non-inferior to enoxaparin 40mg/day administered for 28 to 35 days in THR and for 6 to 10 days for TKR. Non-inferiority with the enoxaparin 30 mg every 12 hours could not be proved.At the time of considering the efficacy of rivaroxaban, this proved to be superior to both enoxaparin regimes in thromboprophylaxis after THR when administered for 31 to 39 days and after TKR for 10 to 14 days; but more bleeding was observed with rivaroxaban.No direct comparisons have been made between dabigatran and rivaroxaban. No studies assessing the usefulness of these drugs in hip fracture surgery or comparing them with other LMWHs, fondaparinux or vitamin K antagonists have been found.Given the preference patients and health professionals for the orally administered drugs added to the cost similar to that of standard treatment with enoxaparin and to saving the cost of home nursing, dabigatran and rivaroxaban become useful for the thromboprophylaxis after THR and TKR inpatients under 75 years old, with not kidney or liver disease or high risk of bleeding.
Project Status: Completed
Year Published: 2011
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Morpholines
  • Orthopedic Procedures
  • Pyridines
  • Venous Thromboembolism
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
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