[Direct-acting oral anticoagulants for postoperative thrombosis prophylaxis]

Luxardo R, Ciapponi A, Alfie V, Argento F, Klappenbach R, Augustovski F, Bardach A, García Martí S, Alcaraz A, Pichon-Riviere A.
Record ID 32018001596
Original Title: Anticoagulantes orales directos en trombo profilaxis postoperatoria
Authors' recomendations: Moderate-quality evidence suggests that direct-acting oral anticoagulants (rivaroxaban, apixaban, dabigatran) considerably reduce the risk of venous thromboembolism after major orthopedic surgery when compared to low-molecular-weight heparins (LMWH), with no coagulation time check-up requirements. There seems to be no significant differences in terms of safety, although apixaban might have a better safety profile than LMWH. Low-quality evidence suggests that there would not be differences regarding the safety or efficacy of direct-acting anticoagulants versus low-molecular-weight heparins in patients requiring non-orthopedic surgery. However, there is no evidence available for all types of non-orthopedic surgeries. The clinical practice guidelines recommend using direct-acting oral anticoagulants or LMWH after a major orthopedic surgery. They do not mention this technology for non-orthopedic surgeries. Sponsors from high-income countries cover this technology as prophylaxis for major orthopedic surgeries. The Latin-American health sponsors do not cover this therapy. The Canadian Agency for Drugs and Technologies in Health conclude that apixaban is more cost-effective than enoxaparin in preventing thromboembolism in major orthopedic surgery.
Project Status: Completed
Year Published: 2021
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Postoperative Care
  • Postoperative Complications
  • Anticoagulants
  • Thrombosis
  • Venous Thromboembolism
  • Dabigatran
  • Rivaroxaban
  • Factor Xa Inhibitors
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)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.