Document Detail

Rivaroxaban, an oral, direct factor Xa inhibitor: a new option for thromboprophylaxis.
MedLine Citation:
PMID:  22691670     Owner:  NLM     Status:  MEDLINE    
Patients undergoing major orthopedic surgery, including total hip arthroplasty (THA) and total knee arthroplasty (TKA), are at high risk for developing venous thromboembolism (VTE). Although largely a preventable complication, VTE develops in a significant proportion of patients, highlighting the need for improved methods of VTE prevention. Current thromboprophylactic options are limited by unpredictable pharmacokinetics and pharmacodynamics (vitamin K antagonists), parenteral/subcutaneous administration (heparin and low-molecular-weight heparins), complicated dosing, and increased risk of bleeding.Rivaroxaban is an oral, direct Factor Xa inhibitor that has recently received marketing authorization in the United States for prophylaxis of deep vein thrombosis in patients undergoing hip or knee replacement surgery. The clinical pharmacology of rivaroxaban supports a convenient, oral, once-daily dosing regimen without the need for routine coagulation monitoring after THA or TKA. A comprehensive phase II and III study program supports its safety and efficacy for VTE prevention after THA or TKA. Phase III results have demonstrated the superior efficacy of rivaroxaban regimens compared with enoxaparin regimens, with similar rates of major bleeding. This article provides an overview of the phase II and III results that support the use of this agent for the prevention of VTE after elective total hip or knee replacement.
Louis M Kwong
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Orthopedics     Volume:  35     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-13     Completed Date:  2012-11-13     Revised Date:  2012-12-31    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e932-8;discussion e939     Citation Subset:  IM    
Copyright Information:
Copyright 2012, SLACK Incorporated.
Department of Orthopaedic Surgery, Harbor–UCLA Medical Center, Torrance, California 90509, USA. lkwong@
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MeSH Terms
Administration, Oral
Dose-Response Relationship, Drug
Factor Xa / antagonists & inhibitors*
Morpholines / administration & dosage*
Postoperative Complications / prevention & control*
Thiophenes / administration & dosage*
Treatment Outcome
Venous Thromboembolism / prevention & control*
Reg. No./Substance:
0/Morpholines; 0/Thiophenes; 0/rivaroxaban; EC Xa
Comment In:
Orthopedics. 2012 Nov;35(11):919; discussion 919   [PMID:  23127435 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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