Emerging options for thromboprophylaxis after orthopedic surgery: a review of clinical data.

In four randomized, controlled studies of patients undergoing orthopedic surgery, the antithrombotic efficacy and safety of subcutaneous fondaparinux 2.5 mg once/day were compared with those of subcutaneous enoxaparin regimens that were approved by the United States Food and Drug Administration. In patients undergoing elective hip replacement surgery, fondaparinux significantly reduced the frequency of venous thromboembolism (VTE). However, in a second trial that compared fondaparinux with enoxaparin 30 mg twice/day beginning 12-24 hours after surgery, a 26% risk reduction in favor of fondaparinux was not statistically significant. In patients undergoing elective knee replacement surgery, fondaparinux significantly reduced the risk of VTE compared with enoxaparin without increasing the risk of clinically relevant bleeding, although the risk of major bleeding defined by the bleeding index was significantly higher with fondaparinux. Fondaparinux was superior to enoxaparin 40 mg once/day in the setting of hip fracture surgery, with no increased risk of major bleeding. Meta-analysis of the four studies confirms the superior antithrombotic efficacy of fondaparinux over enoxaparin in orthopedic surgery and suggests that the risk of major bleeding is similar to that of enoxaparin when the first dose of fondaparinux is given at least 6 hours after surgery.
AuthorsBob L Lobo
JournalPharmacotherapy (Pharmacotherapy) Vol. 24 Issue 7 Pt 2 Pg. 66S-72S (Jul 2004) ISSN: 0277-0008 [Print] United States
PMID15317401 (Publication Type: Comparative Study, Journal Article, Review)
Chemical References
  • Anticoagulants
  • Enoxaparin
  • Polysaccharides
  • fondaparinux
  • Anticoagulants (adverse effects, therapeutic use)
  • Enoxaparin (adverse effects, therapeutic use)
  • Humans
  • Meta-Analysis as Topic
  • Orthopedic Procedures (adverse effects)
  • Polysaccharides (adverse effects, therapeutic use)
  • Randomized Controlled Trials as Topic
  • Thromboembolism (prevention & control)
  • Venous Thrombosis (prevention & control)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research network!

Choose Username:
Verify Password: