Oral rivaroxaban for the prevention of symptomatic venous thromboembolism after elective hip and knee replacement
Oral rivaroxaban for the prevention of symptomatic venous thromboembolism after elective hip and knee replacement
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DOI：
10.1302/0301-620x.91b5.21691
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发表时间：
2009-05-01
影响因子：
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通讯作者：
Lassen, M. R.
中科院分区：
文献类型：
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作者：
Eriksson, B. I.;Kakkar, A. K.;Lassen, M. R.
每日一次剂量的利伐沙班10 mg，一种口服的直接Xa因子抑制剂，与依诺肝素40 mg皮下注射每日一次预防静脉血栓栓塞进行了比较，在三项择期髋关节和膝关节置换术患者的研究中（记录程序）。对这些研究数据的汇总分析（n = 9581）显示利伐沙班在降低两周时症状性静脉血栓栓塞和全因死亡复合事件的发生率方面比依诺肝素更有效（分别为0.4%和0.8%，比值比0.44; 95%置信区间0.23至0.79; p = 0.005），以及计划用药期结束时（分别为0.5%和1.3%;比值比0.38; 95%置信区间0.22至0.62; p < 0.001）。两组患者在两周内和计划用药期结束时的大出血发生率相似（均为0.2%）（0.3% vs 0.2%）。在预防症状性静脉血栓栓塞和全因死亡方面，术后6 - 8小时开始使用利伐沙班比前一天晚上开始使用依诺肝素更有效，而不会增加大出血。
A once-daily dose of rivaroxaban 10 mg, an oral, direct Factor Xa inhibitor, was compared with enoxaparin 40 mg subcutaneously once daily for prevention of venous thromboembolism in three studies of patients undergoing elective hip and knee replacement (RECORD programme).A pooled analysis of data from these studies (n = 9581) showed that rivaroxaban was more effective than enoxaparin in reducing the incidence of the composite of symptomatic venous thromboembolism and all-cause mortality at two weeks (0.4% vs 0.8%, respectively, odds ratio 0.44; 95% confidence interval 0.23 to 0.79; p = 0.005), and at the end of the planned medication period (0.5% vs 1.3%, respectively; odds ratio 0.38; 95% confidence interval 0.22 to 0.62; p < 0.001). The rate of major bleeding was similar at two weeks (0.2% for both) and at the end of the planned medication period (0.3% vs 0.2%).Rivaroxaban started six to eight hours after surgery was more effective than enoxaparin started the previous evening in preventing symptomatic venous thromboembolism and all-cause mortality, without increasing major bleeding.