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ACP Journal Club |21 October 2008

Thromboprophylaxis with rivaroxaban or enoxaparin did not differ for major bleeding in knee arthroplasty

Pieter W. Kamphuisen, MD

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Lassen MR, Ageno W, Borris LC, et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty. N Engl J Med. 2008;358:2776-86. 18579812

Hematol/Thrombo:

In patients having total knee arthroplasty, what is the efficacy and safety of thromboprophylaxis with rivaroxaban compared with enoxaparin?
Randomized controlled trial (RCT) (Regulation of Coagulation in Orthopedic Surgery to Prevent Deep Venous Thrombosis and Pulmonary Embolism 3 [RECORD3]).
Concealed.*
Blinded (clinicians, patients, and outcome assessors).*
30 to 35 days after last dose of study drug.
147 centers in 19 countries.
2531 patients 28 to 91 years of age (mean age 68 y, 68% women, based on 2459 patients) who were scheduled to have total knee arthroplasty. Exclusion criteria included active bleeding or high risk for bleeding, contraindications to enoxaparin, conditions preventing bilateral venography, substantial liver disease, concomitant use of protease inhibitors for HIV infection, planned intermittent pneumatic compression, or need for anticoagulant therapy.
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Kamphuisen PW. Thromboprophylaxis with rivaroxaban or enoxaparin did not differ for major bleeding in knee arthroplasty. Ann Intern Med. ;149:JC4–7. doi: 10.7326/0003-4819-149-8-200810210-02007

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Published: Ann Intern Med. 2008;149(8):JC4-7.

DOI: 10.7326/0003-4819-149-8-200810210-02007

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