Dabigatran and rivaroxaban versus enoxaparin for anticoagulant therapy after total knee or hip arthroplasty

doi:10.3969/j.issn.2095-4344.2013.13.016

Abstract

Abstract:

BACKGROUND: The enoxaparin is commonly used in clinic to prevent venous thrombosis after total hip or total knee replacement, but it is not 100% effective and safe.
OBJECTIVE: To systematically evaluate the efficacy and safety of dabigatran and rivaroxaban versus enoxaparin in preventing venous thrombosis after total knee or hip arthroplasty in the clinical randomized controlled trials.
METHODS: A computer-based online search of PubMed database, ScienceDirect database, Cochrane Library, CBM database and CNKI database was performed for the randomized controlled trials on efficacy and safety of dabigatran and rivaroxaban versus enoxaparin for anticoagulant therapy after total knee or hip arthroplasty. The methodological quality of included studies was evaluated, and the statistical software was RevMan5.1.0.
RESULTS AND CONCLUSION: A total of 14 randomized controlled trials including 17 212 patients were included. Meta-analysis showed that the incidences of total vein thrombosis, large vein thrombosis and symptomatic vein thrombosis in the rivaroxaban group were lower than those in the enoxaparin group; the incidence of deep vein thrombosis in the rivaroxaban group and dabigatran group was lower than that in the enoxaparin group; there was significant difference of incidence of deep vein thrombosis between rivaroxaban group, dabigatran group and dabigatran group. It indicates that the effect of new oral anticoagulants for the prevention of deep vein thrombosis after total hip or total knee arthroplasty is superior to enoxaparin, and rivaroxaban is better than dabigatran.

Key words: bone and joint implants, evidence-based medicine of bone and joint implants, rivaroxaban, dabigatran, enoxaparin, deep vein thrombosis, total hip arthroplasty, total knee arthroplasty, effectiveness, safety, randomized controlled trials, Meta-analysis

CLC Number:

R318

Ruan Jia-li, Lü Tao, Miao Jing-jing, Chen Ming-yi, Han Zhong-yu, Tian Jing. Dabigatran and rivaroxaban versus enoxaparin for anticoagulant therapy after total knee or hip arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(13): 2390-2398.

Figures/Tables 9

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