Apixaban versus enoxaparin in elective major orthopedic surgery: a clinical review

Clin Appl Thromb Hemost. 2015 Mar;21(2):115-9. doi: 10.1177/1076029614546328. Epub 2014 Aug 13.

Abstract

Despite current guidelines recommendations about anticoagulant prophylaxis, many studies have shown an high venous thromboembolism (VTE) incidence in patients undergoing total hip and knee arthroplasty. A number of anticoagulants are currently available, but they have some limitations that affect their applicability and consequently their effectiveness. Several new oral anticoagulants (NOACs) have been developed in an attempt to overcome these limitations. Apixaban is a NOAC that selectively inhibits the coagulation factor Xa; it is approved for the prevention of VTE after total hip replacement and total knee replacement surgery. This review examines the results of main trials designed to test efficacy and safety of apixaban in major elective orthopedic surgery.

Keywords: apixaban; hip replacement; knee replacement; major orthopedic surgery; phase 3 clinical trials; review; venous thromboembolism.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Administration, Oral
  • Arthroplasty, Replacement, Hip*
  • Enoxaparin / adverse effects
  • Enoxaparin / therapeutic use*
  • Factor Xa Inhibitors / adverse effects
  • Factor Xa Inhibitors / therapeutic use*
  • Humans
  • Pyrazoles / adverse effects
  • Pyrazoles / therapeutic use*
  • Pyridones / adverse effects
  • Pyridones / therapeutic use*
  • Venous Thromboembolism / prevention & control*

Substances

  • Enoxaparin
  • Factor Xa Inhibitors
  • Pyrazoles
  • Pyridones
  • apixaban