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Patients who undergo total hip replacement have very high perioperative risk for venous thromboembolism (VTE). Low-molecular-weight heparins (LMWHs; e.g., enoxaparin, dalteparin [Fragmin]) or vitamin K antagonists (e.g., warfarin) are recommended to lower risk, but LMWHs require subcutaneous injections, and warfarin requires lab monitoring. Oral apixaban (a factor Xa inhibitor that is not yet FDA approved) requires no lab monitoring, is convenient, and potentially is as effective as LMWHs or warfarin for preventing VTE.
Previous data suggested that apixaban was as effective as enoxaparin for VTE prevention in patients who had undergone knee replacement (JW Gen Med Aug 11 2009). Now, the same research group has conducted an industry-sponsored…