Oral Anticoagulation Without Therapeutic Monitoring: Dabigatran After Hip Replacement

Anticoagulation for 5 to 11 days after hip replacement surgery can reduce the incidence of venographically detected deep venous thrombosis (DVT) to about 20%. Longer treatment courses may further reduce the incidence, but adherence to anticoagulation often declines after hospital discharge. Dabigatran etexilate is an investigational oral direct thrombin inhibitor that has been shown to be safe and effective for the prevention of DVT after orthopedic surgery and does not require therapeutic monitoring.

In a manufacturer-funded, double-blind, noninferiority trial, 3494 patients were randomized to receive dabigatran etexilate (150 or 220 mg daily) or subcutaneous enoxaparin (40 mg daily) for 28 to 35 days after hip replacement surgery (all pati…