Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty

@article{Anderson2018AspirinOR,
  title={Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty},
  author={David R Anderson and Michael Dunbar and John J. Murnaghan and Susan R. Kahn and Peter L. Gross and Michael E. Forsythe and St{\'e}phane Pelet and William Fisher and Etienne L. Belzile and Sean Dolan and Mark Andrew Crowther and Eric Bohm and Steven J MacDonald and Wade T Gofton and Paul Kim and David J. Zukor and Susan Pleasance and Pantelis Andreou and Steve Doucette and Chris Theriault and Abongnwen Abianui and Marc Carrier and Michael J. Kovacs and Marc Alan Rodger and Doug Coyle and Philip Stephen Wells and Pascal-Andr{\'e} Vendittoli},
  journal={The New England Journal of Medicine},
  year={2018},
  volume={378},
  pages={699–707}
}
Background Clinical trials and meta‐analyses have suggested that aspirin may be effective for the prevention of venous thromboembolism (proximal deep‐vein thrombosis or pulmonary embolism) after total hip or total knee arthroplasty, but comparisons with direct oral anticoagulants are lacking for prophylaxis beyond hospital discharge. [...] Key Method All the patients received once‐daily oral rivaroxaban (10 mg) until postoperative day 5 and then were randomly assigned to continue rivaroxaban or switch to…Expand
Venous Thromboembolic Prophylaxis After Total Hip and Knee Arthroplasty.
TLDR
As aspirin has increased in popularity over the past decade because it is effective, and it is an oral agent that does not require monitoring, and the true efficacy of aspirin needs to be determined in multicenter randomized clinical trials.
A comparison of aspirin against rivaroxaban for venous thromboembolism prophylaxis after hip or knee arthroplasty: A meta-analysis
TLDR
Aspirin was not significantly different to rivaroxaban for prevention of VTE or adverse events after TKA or THA, and more large randomized studies are needed to add to this body of evidence.
Clinical Effectiveness of Aspirin as Multimodal Thromboprophylaxis in Primary Total Hip and Knee Arthroplasty: A Review of 6078 Cases.
TLDR
The results of this study clearly show that aspirin, as part of a multimodal thromboprophylactic regime, is an effective and safe regime in preventing venous thromboembolism with respect to risk of deep veinThrombosis or pulmonary embolism when compared to LMWH.
Clinical Effectiveness and Safety of Aspirin for Venous Thromboembolism Prophylaxis After Total Hip and Knee Replacement: A Systematic Review and Meta-analysis of Randomized Clinical Trials.
TLDR
Clinical effectiveness and safety profile, aspirin did not differ statistically significantly from other anticoagulants used for VTE prophylaxis after THR and TKR and future trials should focus on noninferiority analysis of aspirin compared with alternative anticoageulants and cost-effectiveness.
Bleeding and thromboembolism risk of standard antithrombotic prophylaxis after hip or knee replacement within an enhanced recovery program.
TLDR
It is found that bleeding complications are significantly more common than VTE complications after THA or TKA within an ERAS protocol and the cost-benefit ratio of antithrombotic prophylaxis by LMWH or DOACs in this context should be reassessed.
Rivaroxaban versus aspirin in prevention of venous thromboembolism following total joint arthroplasty or hip fracture surgery: a meta-analysis
TLDR
There was no significant difference between aspirin and rivaroxaban in prevention of venous thromboembolism following total joint arthroplasty or hip fracture surgery and aspirin may be an effective, safe, convenient, and cheap alternative for prevention of VTE.
Aspirin versus rivaroxaban in postoperative bleeding after total knee arthroplasty: a retrospective case-matched study
TLDR
Aspirin and rivaroxaban were effective and safe as VTE chemoprophylaxis in total knee arthroplasty and there were no bleeding-related complications or VTE in either group.
Aspirin Compared with Anticoagulation to Prevent Venous Thromboembolism After Knee or Hip Arthroplasty: a Large Retrospective Cohort Study
TLDR
Postoperative thromboprophylaxis with aspirin-only was not associated with a higher risk of postoperative venous thromboembolism compared with anticoagulants after hip or knee arthroplasty.
Aspirin versus enoxaparin for the initial prevention of venous thromboembolism following elective arthroplasty of the hip or knee: A systematic review and meta-analysis.
TLDR
The results of this meta-analysis provide cautious endorsement for the position that aspirin is likely a safe alternative to enoxaparin for TKA patients as part of a multimodal enhanced recovery protocol, but care is advised for THA patients owing to a lack of data from trials.
Efficacy and safety of aspirin and rivaroxaban for venous thromboembolism prophylaxis after total hip or knee arthroplasty
TLDR
Aspirin seemed to have better effect than aspirin in reducing the risk of DVT, and aspirin was safer than rivaroxaban in decreasing the blood transfusion rate.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 25 REFERENCES
Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4): a randomised trial
TLDR
Oral rivaroxaban 10 mg once daily for 10-14 days was significantly superior to subcutaneous enoxaparin 30 mg given every 12 h for the prevention of venous thromboembolism after total knee arthroplasty.
Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty.
TLDR
Rivaroxaban was superior to enoxaparin for thromboprophylaxis after total knee arthroplasty, with similar rates of bleeding.
Does aspirin have a role in venous thromboembolism prophylaxis in total knee arthroplasty patients?
TLDR
Patients who received aspirin VTE prophylaxis (VTEP) had lower odds for thromboembolism compared to warfarin patients but with similar odds compared with injectable VTEP; there were no differences in risk of bleeding, infection, or mortality after adjustment.
Aspirin Versus Low-Molecular-Weight Heparin for Extended Venous Thromboembolism Prophylaxis After Total Hip Arthroplasty
TLDR
Extended prophylaxis for 28 days with aspirin was noninferior to and as safe as dalteparin for the prevention of VTE after THA in patients who initially received daltEParin for 10 days.
Extended-duration prophylaxis against venous thromboembolism after total hip or knee replacement: a meta-analysis of the randomised trials
TLDR
Among patients undergoing total hip or knee replacement, extended-duration prophylaxis significantly reduces the frequency of symptomatic venous thromboembolism and the reduction in risk is equivalent to about 20 symptomatic events per 1000 patients treated.
Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty.
TLDR
A once-daily, 10-mg oral dose of rivaroxaban was significantly more effective for extended thromboprophylaxis than a once- daily, 40-mg subcutaneous dose of enoxaparin in patients undergoing elective total hip arthroplasty.
Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomised controlled trial
TLDR
Extended thromboprophylaxis with rivaroxaban was significantly more effective than short-term enoxaparin plus placebo for the prevention of venous thromboembolism, including symptomatic events, in patients undergoing total hip arthroplasty.
Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial
TLDR
Results show that aspirin reduces the risk of pulmonary embolism and deep-vein thrombosis by at least a third throughout a period of increased risk, and there is now good evidence for considering aspirin routinely in a wide range of surgical and medical groups at high risk of venous thromboembolism.
Reduction of out-of-hospital symptomatic venous thromboembolism by extended thromboprophylaxis with low-molecular-weight heparin following elective hip arthroplasty: a systematic review.
TLDR
The absolute reduction in symptomatic venous thromboembolism attributed to extended prophylaxis in some studies and meta-analyses seems to have been overestimated.
Prevention of VTE in orthopedic surgery patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.
TLDR
Optimal strategies for thromboprophylaxis after major orthopedic surgery include pharmacologic and mechanical approaches.
...
1
2
3
...