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Oral Apixaban Halved VTE Rate After Joint Replacement

ORLANDO — Oral apixaban reduced the incidence of major venous thromboembolism after joint replacement surgery by approximately half compared with enoxaparin, with no increased risk of bleeding, investigators have reported.

Of approximately 7,000 patients who underwent thromboprophylaxis after surgery, major VTE occurred in 0.68% of those who had received apixaban, compared with 1.50% who had been given enoxaparin. This was a significant difference, Gary E. Raskob, Ph.D., said.

Prevention of major venous thromboembolism is “a significant issue in health care in the United States,” where the number of knee and hip replacements is expected to increase, said Dr. Raskob, dean of the College of Public Health at the University of Oklahoma Health Sciences Center in Oklahoma City. To provide more precise estimates of the incidence of major VTE and safety outcomes, the researchers combined data from two phase III, randomized, double-blind trials of patients who had undergone knee (ADVANCE-2 study) or hip (ADVANCE-3) replacement. A total of 8,464 were randomized to apixaban, a novel orally administered factor Xa inhibitor (4,236 patients), or enoxaparin (4,228 patients).

Efficacy results related to VTE were based on 3,394 patients in each group. Major VTE occurred in 23 patients in the apixaban group (0.68%), vs. 51 patients in the enoxaparin group (1.50%).

Bleeding results were based on 4,174 apixaban patients and 4,228 enoxaparin patients. Major bleeding occurred in 31 patients in the apixaban group and 32 in the enoxaparin group (0.74% vs. 0.77%). Major bleeding at the surgical site occurred in 26 in the apixaban group and 27 in the enoxaparin group.

Dr. Raskob has financial relationships with Bristol-Meyers Squibb, Pfizer, Bayer, Johnson & Johnson, Sanofi Aventis, and Daiichi Sankyo.

To see an interview with Dr. Gary E. Raskob, go to

Source Heidi Splete/Elsevier Global Medical Newswww.rheumatologynews.com

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ORLANDO — Oral apixaban reduced the incidence of major venous thromboembolism after joint replacement surgery by approximately half compared with enoxaparin, with no increased risk of bleeding, investigators have reported.

Of approximately 7,000 patients who underwent thromboprophylaxis after surgery, major VTE occurred in 0.68% of those who had received apixaban, compared with 1.50% who had been given enoxaparin. This was a significant difference, Gary E. Raskob, Ph.D., said.

Prevention of major venous thromboembolism is “a significant issue in health care in the United States,” where the number of knee and hip replacements is expected to increase, said Dr. Raskob, dean of the College of Public Health at the University of Oklahoma Health Sciences Center in Oklahoma City. To provide more precise estimates of the incidence of major VTE and safety outcomes, the researchers combined data from two phase III, randomized, double-blind trials of patients who had undergone knee (ADVANCE-2 study) or hip (ADVANCE-3) replacement. A total of 8,464 were randomized to apixaban, a novel orally administered factor Xa inhibitor (4,236 patients), or enoxaparin (4,228 patients).

Efficacy results related to VTE were based on 3,394 patients in each group. Major VTE occurred in 23 patients in the apixaban group (0.68%), vs. 51 patients in the enoxaparin group (1.50%).

Bleeding results were based on 4,174 apixaban patients and 4,228 enoxaparin patients. Major bleeding occurred in 31 patients in the apixaban group and 32 in the enoxaparin group (0.74% vs. 0.77%). Major bleeding at the surgical site occurred in 26 in the apixaban group and 27 in the enoxaparin group.

Dr. Raskob has financial relationships with Bristol-Meyers Squibb, Pfizer, Bayer, Johnson & Johnson, Sanofi Aventis, and Daiichi Sankyo.

To see an interview with Dr. Gary E. Raskob, go to

Source Heidi Splete/Elsevier Global Medical Newswww.rheumatologynews.com

ORLANDO — Oral apixaban reduced the incidence of major venous thromboembolism after joint replacement surgery by approximately half compared with enoxaparin, with no increased risk of bleeding, investigators have reported.

Of approximately 7,000 patients who underwent thromboprophylaxis after surgery, major VTE occurred in 0.68% of those who had received apixaban, compared with 1.50% who had been given enoxaparin. This was a significant difference, Gary E. Raskob, Ph.D., said.

Prevention of major venous thromboembolism is “a significant issue in health care in the United States,” where the number of knee and hip replacements is expected to increase, said Dr. Raskob, dean of the College of Public Health at the University of Oklahoma Health Sciences Center in Oklahoma City. To provide more precise estimates of the incidence of major VTE and safety outcomes, the researchers combined data from two phase III, randomized, double-blind trials of patients who had undergone knee (ADVANCE-2 study) or hip (ADVANCE-3) replacement. A total of 8,464 were randomized to apixaban, a novel orally administered factor Xa inhibitor (4,236 patients), or enoxaparin (4,228 patients).

Efficacy results related to VTE were based on 3,394 patients in each group. Major VTE occurred in 23 patients in the apixaban group (0.68%), vs. 51 patients in the enoxaparin group (1.50%).

Bleeding results were based on 4,174 apixaban patients and 4,228 enoxaparin patients. Major bleeding occurred in 31 patients in the apixaban group and 32 in the enoxaparin group (0.74% vs. 0.77%). Major bleeding at the surgical site occurred in 26 in the apixaban group and 27 in the enoxaparin group.

Dr. Raskob has financial relationships with Bristol-Meyers Squibb, Pfizer, Bayer, Johnson & Johnson, Sanofi Aventis, and Daiichi Sankyo.

To see an interview with Dr. Gary E. Raskob, go to

Source Heidi Splete/Elsevier Global Medical Newswww.rheumatologynews.com

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