| Apixaban versus enoxaparin for thromboprophylaxis after total hip or knee arthroplasty: a meta-analysis of randomized controlled trials. | |
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MedLine Citation:
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PMID: 22882859 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Enoxaparin is routinely used for prevention of venous thromboembolism (VTE) after total hip or knee arthroplasty. The purpose of this study was to compare the efficacy and safety of apixaban, a newly oral direct inhibitor of factor Xa versus enoxaparin. METHODS: We performed a meta-analysis of relevant randomized-controlled trials (RCTs) identified in PubMed, Cochrane Library, Embase China Biological Medical Literature database, Countries Journal full-text database, VIP database, and WanFang database. The primary efficacy outcome for our meta-analysis was all VTE and all-cause mortality. The secondary efficacy outcomes included major VTE, non-fatal pulmonary embolism, and mortality. The primary safety outcome was bleeding events, categorized as major, clinically relevant non-major, or minor events. RESULTS: Four RCTs, involving 14 065 patients, were included in our meta-analysis. Compared to enoxaparin, thromboprophylaxis with apixaban was associated with significantly fewer VTE and all-cause mortality (8346 patients, risk ratio (RR): 0.63, 95%CI 0.42 - 0.95) and similar incidence of bleeding events (major bleeding, 11 525 patients, RR 0.76, 95%CI 0.43 - 1.33; clinically relevant non-major bleeding, 11 525 patients, RR 0.83, 95%CI 0.69 - 1.01; and minor bleeding, 11 828 patients, RR 0.93, 95%CI 0.79 - 1.09). However, our meta-analysis revealed similar effects of apixaban with enoxaparin for thromboprophylaxis with regard to the secondary efficacy outcomes. CONCLUSIONS: Apixaban was more effective than recommended dose of enoxaparin and had a similar safety profile for thromboprophylaxis after hip and knee arthroplasty. But more evidence, especially well designed head-to-head RCTs, is needed to confirm the superior efficacy of apixaban. |
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Authors:
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Xiu-Min Li; Shi-Guang Sun; Wei-Dong Zhang |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Chinese medical journal Volume: 125 ISSN: 0366-6999 ISO Abbreviation: Chin. Med. J. Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-08-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7513795 Medline TA: Chin Med J (Engl) Country: China |
Other Details:
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Languages: eng Pagination: 2339-45 Citation Subset: IM |
Affiliation:
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Department of Pharmacy, the Military General Hospital of Beijing PLA, Beijing 100700, China (Email: lixiuminpla@yahoo.cn). |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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