Rivaroxaban for the prevention of venous thromboembolism following major orthopedic surgery: the RECORD trials

Abstract

Patients undergoing total hip or knee arthroplasty face an increased risk for venous thromboembolism in the days and weeks following surgery. Hence, the routine application of prophylactic strategies is currently recommended. These include parenteral anticoagulants such as the low-molecular-weight heparins or fondaparinux and oral anticoagulants such as warfarin. New anticoagulant drugs are rapidly becoming available, including drugs that are administered orally, at fixed doses and without laboratory monitoring. Rivaroxaban is the first of a new class of anticoagulants: the selective, direct Factor Xa inhibitors. It has completed clinical evaluation in the setting of major orthopedic surgery and is now approved in many countries for the prevention of venous thromboembolism in patients undergoing total knee and hip arthroplasty. In this paper, we will review the trial data now supporting the clinical use of rivaroxaban and will discuss the potential role of this agent in daily clinical practice.

Keywords::

• prophylaxis
• rivaroxaban
• total hip arthroplasty
• total knee arthroplasty
• venous thromboembolism

Financial & competing interests disclosure

Walter Ageno was a member of the steering committee of one of the trials discussed in this manuscript and received honoraria from Bayer Schering Pharma AG. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.