Dabigatran or Rivaroxaban versus other anticoagulants for thromboprophylaxis after major orthopedic surgery: systematic review of comparative clinical-effectiveness and safety

Ndegwa S, Moulton K, Argaez C
Record ID 32010001045
English
Authors' objectives:

To determine the clinical effectiveness and safety of dabigatran or rivaroxaban compared to low-molecular-weight heparins (LMWH), unfractionated heparin, warfarin, or fondaparinux for thromboprophylaxis after elective total hip replacement, elective total knee replacement, or hip fracture surgery

Authors' recommendations: The evidence that dabigatran is at least as effective as enoxaparin for thromboprophylaxis after total hip replacement (THR) or total knee replacement (TKR) is conflicting. Three phase-3 trials evaluating rivaroxaban showed superior clinical effectiveness over enoxaparin in preventing venous thromboembolism (VTE) after THR or TKR. The Canadian Expert Drug Advisory Committee (CEDAC) recommended that rivaroxaban, but not dabigatran, be listed in publicly funded drug plans for prophylaxis of VTE after TKR or THR. No head-to-head trials compare rivaroxaban with dabigatran, or compare either drug to other anticoagulants. There is no evidence to support the use of dabigatran or rivaroxaban in patients undergoing hip fracture surgery.
Details
Project Status: Completed
URL for project: http://www.cadth.ca/media/pdf/M0006_Rivaroxaban_and_Dabigatran_L3_e.pdf
Year Published: 2009
URL for published report: n/a
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Anticoagulants
  • Arthroplasty, Replacement, Hip
  • Morpholines
  • Pyridines
  • Thrombosis
  • Venous Thromboembolism
  • Dabigatran
  • Rivaroxaban
Contact
Organisation Name: Canadian Agency for Drugs and Technologies in Health
Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;
Contact Name: requests@cadth.ca
Contact Email: requests@cadth.ca
Copyright: <p>Canadian Agency for Drugs and Technologies in Health (CADTH)</p>
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