Newer Oral Anticoagulants Are as Efficacious as Enoxaparin in Preventing Symptomatic Venous Thromboembolism

Whether newer oral anticoagulant drugs are superior to low-molecular-weight heparins for preventing symptomatic venous thromboembolism (VTE) after total hip or knee arthroplasty is unclear. In this meta-analysis of 16 randomized trials that involved 39,000 patients, investigators compared oral rivaroxaban (Xarelto), dabigatran (Pradaxa), and apixaban with subcutaneous enoxaparin (Lovenox) for preventing symptomatic VTE after total hip or knee arthroplasty.

Treatment duration was 6 to 39 days. Compared with enoxaparin, rivaroxaban significantly lowered incidence of symptomatic VTE (relative risk, 0.5), but incidence with dabigatran and apixaban was similar to that with enoxaparin. Clinically relevant bleeding was significantly more common wit…