[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
Spanish
Original Title:
Anticoagulantes orales directos en trombo profilaxis postoperatoria
Authors' recommendations:
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.
Details
Project Status:
Completed
Year Published:
2021
URL for published report:
https://www.iecs.org.ar/publicacion/?id=19869
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
Contact
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.