Oral Drug to Prevent Venous Thrombosis After Knee Replacement

Direct inhibitors of factor Xa that can be given orally in fixed doses and require no laboratory monitoring (unlike warfarin) are under investigation. One such drug is rivaroxaban (JW Gen Med Jul 24 2008); another is apixaban.

In an industry-sponsored double-blind trial, 3195 patients who underwent total knee replacement were randomized to receive either oral apixaban or subcutaneous enoxaparin (a low-molecular-weight heparin) for thromboprophylaxis following surgery. After treatment for 10 to 14 days, bilateral leg venography was performed. The incidence of the primary efficacy outcome (asymptomatic and symptomatic deep venous thrombosis, nonfatal pulmonary embolism, and death from any cause during treatment) was similar in the two groups (…