scholarly journals Efficacy and safety outcomes of oral anticoagulants and antiplatelet drugs in the secondary prevention of venous thromboembolism: systematic review and network meta-analysis

BMJ ◽  
2013 ◽  
Vol 347 (aug30 1) ◽  
pp. f5133-f5133 ◽  
Author(s):  
L. A. Castellucci ◽  
C. Cameron ◽  
G. Le Gal ◽  
M. A. Rodger ◽  
D. Coyle ◽  
...  
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Secondary Prevention ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Antiplatelet Drugs ◽  
Efficacy And Safety ◽  
Safety Outcomes

scholarly journals Efficacy and Safety of Enoxaparin versus New Oral Anticoagulants to Prevent Venous Thromboembolism after Total Hip Replacement: A Systematic Review and Meta-Analysis

2022 ◽  
Vol 12 (1) ◽  
pp. 107
Author(s):  
Mohammed Farhan A Alfarhan
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
New Oral Anticoagulants ◽  
Clinical Endpoint ◽  
Efficacy And Safety ◽  
Total Hip

Prophylactic anticoagulant therapy is recommended for reducing the risk of venous thromboembolism (VTE) after a total hip replacement (THR). However, it is not clear which anticoagulant is preferable. Hence, a systematic review and meta-analysis of randomized double-blind controlled trials (RDBCTs) were conducted to investigate the clinical efficacy and safety of enoxaparin in comparison with newer oral anticoagulants for the prevention of VTE after THR. The Cochrane Library, Scopus, Web of Science, Embase, and PubMed/Medline databases were used for PICO search strategy. Relative risks (RR) of symptomatic VTE, clinically relevant bleeding, mortality, and a net clinical endpoint were estimated employing a random effect meta-analysis. ITC and RevMan software were used for indirect and direct comparisons, respectively. Nine RDBCTs comprising 24,584 patients were included. As compared to enoxaparin, a reduced risk for symptomatic VTE was observed with rivaroxaban (confidence interval [CI]: 0.32–0.77; RR: 0.46%) and comparable with apixaban (0.12–1.26; 0.42%) and dabigatran (0.22–2.20; 0.70%). Contrarily to enoxaparin, a greater risk for clinically relevant bleeding was observed with rivaroxaban (1.03–1.48; 1.23%), comparable with dabigatran (0.96–1.33; 1.10%) and reduced with apixaban (0.19–5.66; 0.96%). In indirect or direct comparisons, the interventions did not differ on the net clinical endpoint. In conclusion, the findings of this meta-analysis revealed no significant difference in the efficacy and safety of new oral anticoagulants as compared to enoxaparin for the prevention of VTE after total hip replacement surgery.

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