Use of oral direct factor Xa inhibiting anticoagulants in elective hip and knee arthroplasty : a meta-analysis of efficacy and safety profiles compared with those of low-molecular-weight heparins
Assessing the efficacy and safety profiles of new oral direct Factor Xa (FXa) inhibiting anticoagulants compared with low-molecular-weight heparins (LMWHs) in elective total hip and knee arthroplasty (THA and TKA). The literature review only searched for randomised-controlled trials (RCTs) published before September 2011. Five eligible THA RCTs with a total of 12,184 patients and 5 eligible TKA RCTs with a total of 13,169 patients were identified. Mantel- Haenszel random-effects model was used to create meta-analyses of pooled data for each surgical group. The primary efficacy outcome was the risk of venous thromboembolism (VTE) and all-cause mortality, and the primary safety outcome was the risk of major bleeding. The THA and TKA primary efficacy outcome meta-analyses calculated relative risks (RR) of 0.55 (95% confidence interval 0.32 to 0.94) and 0.68 (95% confidence interval 0.53 to 0.87), respectively in favor of the oral direct FXa inhibitors. The primary safety outcome meta-analyses for the THA and TKA surgical groups revealed an RR of 1.27 (95% confidence interval 0.56 to 2.86) and 0.94 (95% confidence interval 0.44 to 1.98), which shows no significant difference between oral FXa inhibitors and LMWHs. This review demonstrated that oral direct FXa inhibitors have a superior efficacy to LMWHs when used as thromboprophylaxis in both THA and TKA. The safety profile of these new oral anticoagulants was not significantly different to that of LMWHs.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2013 |
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| Erschienen: |
2013 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
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| Enthalten in: |
Current vascular pharmacology - 11(2013), 3 vom: 09. Mai, Seite 366-75 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
As-Sultany, Mohammed [VerfasserIn] |
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| Themen: |
Anticoagulants |
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| Anmerkungen: |
Date Completed 10.12.2013 Date Revised 27.10.2019 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM222511206 |
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| 100 | 1 | |a As-Sultany, Mohammed |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Use of oral direct factor Xa inhibiting anticoagulants in elective hip and knee arthroplasty |b a meta-analysis of efficacy and safety profiles compared with those of low-molecular-weight heparins |
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| 500 | |a Date Completed 10.12.2013 | ||
| 500 | |a Date Revised 27.10.2019 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Assessing the efficacy and safety profiles of new oral direct Factor Xa (FXa) inhibiting anticoagulants compared with low-molecular-weight heparins (LMWHs) in elective total hip and knee arthroplasty (THA and TKA). The literature review only searched for randomised-controlled trials (RCTs) published before September 2011. Five eligible THA RCTs with a total of 12,184 patients and 5 eligible TKA RCTs with a total of 13,169 patients were identified. Mantel- Haenszel random-effects model was used to create meta-analyses of pooled data for each surgical group. The primary efficacy outcome was the risk of venous thromboembolism (VTE) and all-cause mortality, and the primary safety outcome was the risk of major bleeding. The THA and TKA primary efficacy outcome meta-analyses calculated relative risks (RR) of 0.55 (95% confidence interval 0.32 to 0.94) and 0.68 (95% confidence interval 0.53 to 0.87), respectively in favor of the oral direct FXa inhibitors. The primary safety outcome meta-analyses for the THA and TKA surgical groups revealed an RR of 1.27 (95% confidence interval 0.56 to 2.86) and 0.94 (95% confidence interval 0.44 to 1.98), which shows no significant difference between oral FXa inhibitors and LMWHs. This review demonstrated that oral direct FXa inhibitors have a superior efficacy to LMWHs when used as thromboprophylaxis in both THA and TKA. The safety profile of these new oral anticoagulants was not significantly different to that of LMWHs | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Review | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 650 | 7 | |a Factor Xa Inhibitors |2 NLM | |
| 650 | 7 | |a Heparin, Low-Molecular-Weight |2 NLM | |
| 700 | 1 | |a Pagkalos, Joseph |e verfasserin |4 aut | |
| 700 | 1 | |a Yeganeh, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Craigs, Cheryl L |e verfasserin |4 aut | |
| 700 | 1 | |a Korres, Nectarios |e verfasserin |4 aut | |
| 700 | 1 | |a West, Robert M |e verfasserin |4 aut | |
| 700 | 1 | |a Tsiridis, Eleftherios |e verfasserin |4 aut | |
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