Literature DB >> 28217657

Patient compliance with new oral anticoagulants after major orthopaedic surgery: rivaroxaban and dabigatran compared with subcutaneous injection of fondaparinux.

Paolo DI Benedetto1, Luigi Vetrugno2, Dania DE Franceschi1, Renato Gisonni1, Araldo Causero1, Giorgio Della Rocca2.   

Abstract

PURPOSE: the main purpose of our study was to compare patient compliance with the orally administered new oral anticoagulants (NOCs) dabigatran and rivaroxaban compared with subcutaneously injected fondaparinux after major orthopaedic surgery, and to assess patient preference for the oral vs subcutaneous administration route.
METHODS: prophylactic antithrombotic drug therapy with dabigatran (group D; GD, n=32 patients), rivaroxaban (group R; GR, n=38 patients) or fondaparinux (group F; GF, n=30 patients), to prevent deep vein thrombosis, was started immediately after surgery in 100 patients submitted to total hip arthroplasty.
RESULTS: the patients had a mean age of 68.7±11 years and 62% were female. In GD, 87.5% of patients indicated that they preferred oral intake of medications to subcutaneous injection (12.5%). In GR, 84.2% declared a preference for oral administration over subcutaneous injection (15.8%). In GF, a surprisingly high proportion of patients (73.3%; p < 0.001) declared that they preferred subcutaneous administration of medications over the oral route (26.7%). Overall, the rate of compliance with antithrombotic drug therapy was very high, at 99%.
CONCLUSIONS: intake of the NOAs dabigatran and rivaroxaban following hospital discharge is entirely the responsibility of the patient; a high level of patient compliance with these drugs must therefore be demonstrated in order for them to become well accepted within the medical community. The results of this study showed a very high level of compliance both with orally and subcutaneously administered drugs. LEVEL OF EVIDENCE: Level I, randomized clinical study.

Entities:  

Keywords:  compliance; dabigatran; drug administration route; fondaparinux; rivaroxaban; venous thrombosis

Year:  2017        PMID: 28217657      PMCID: PMC5297345          DOI: 10.11138/jts/2016.4.4.214

Source DB:  PubMed          Journal:  Joints        ISSN: 2512-9090


  35 in total

1.  Pharmacokinetics of fondaparinux 1.5 mg once daily in a real-world cohort of patients with renal impairment undergoing major orthopaedic surgery.

Authors:  Xavier Delavenne; Paul Zufferey; Philippe Nguyen; Nadia Rosencher; Charles-Marc Samama; Céline Bazzoli; Patrick Mismetti; Silvy Laporte
Journal:  Eur J Clin Pharmacol       Date:  2012-03-25       Impact factor: 2.953

2.  Dabigatran versus enoxaparin for prevention of venous thromboembolism after hip or knee arthroplasty: a pooled analysis of three trials.

Authors:  R J Friedman; O E Dahl; N Rosencher; J A Caprini; A A Kurth; C W Francis; A Clemens; S Hantel; J M Schnee; B I Eriksson
Journal:  Thromb Res       Date:  2010-05-15       Impact factor: 3.944

Review 3.  Antithrombotic prophylaxis in major orthopaedic surgery: an historical overview and update of current recommendations.

Authors:  Plamen Kinov; Panayot P Tanchev; Martin Ellis; Gershon Volpin
Journal:  Int Orthop       Date:  2013-10-11       Impact factor: 3.075

Review 4.  Clinical experience with novel oral anticoagulants for thromboprophylaxis after elective hip and knee arthroplasty.

Authors:  Cory Messerschmidt; Richard J Friedman
Journal:  Arterioscler Thromb Vasc Biol       Date:  2015-03-12       Impact factor: 8.311

5.  The metabolism and disposition of the oral direct thrombin inhibitor, dabigatran, in humans.

Authors:  Stefan Blech; Thomas Ebner; Eva Ludwig-Schwellinger; Joachim Stangier; Willy Roth
Journal:  Drug Metab Dispos       Date:  2007-11-15       Impact factor: 3.922

6.  Efficacy and safety of dabigatran etexilate for the prevention of venous thromboembolism following total hip or knee arthroplasty. A meta-analysis.

Authors:  Sorrel E Wolowacz; Neil S Roskell; Jonathan M Plumb; Joseph A Caprini; Bengt I Eriksson
Journal:  Thromb Haemost       Date:  2009-01       Impact factor: 5.249

7.  Economic evaluation of dabigatran etexilate for the primary prevention of venous tromboembolic events following major orthopedic surgery in the Netherlands.

Authors:  Maarten J Postma; Bregt S Kappelhoff; Marinus van Hulst; Jacobus R B J Brouwers
Journal:  J Med Econ       Date:  2012-06-07       Impact factor: 2.448

Review 8.  Dabigatran etexilate: a review of its use for the prevention of venous thromboembolism after total hip or knee replacement surgery.

Authors:  Celeste B Burness; Kate McKeage
Journal:  Drugs       Date:  2012-05-07       Impact factor: 9.546

9.  The pharmacokinetics, pharmacodynamics and tolerability of dabigatran etexilate, a new oral direct thrombin inhibitor, in healthy male subjects.

Authors:  Joachim Stangier; Karin Rathgen; Hildegard Stähle; Dietmar Gansser; Willy Roth
Journal:  Br J Clin Pharmacol       Date:  2007-05-15       Impact factor: 4.335

10.  In vitro metabolism of rivaroxaban, an oral, direct factor Xa inhibitor, in liver microsomes and hepatocytes of rats, dogs, and humans.

Authors:  D Lang; C Freudenberger; C Weinz
Journal:  Drug Metab Dispos       Date:  2009-02-05       Impact factor: 3.922

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  2 in total

1.  Aspirin: are patients actually taking it?-A quality assessment study.

Authors:  Steven Lewis; Shaun Kink; Michael Rahl; Ashley Nord; Jason Meldau; Karl Roberts
Journal:  Arthroplast Today       Date:  2018-09-03

2.  Effectiveness and safety of rivaroxaban for the prevention of thrombosis following total hip or knee replacement: A systematic review and meta-analysis.

Authors:  Jichao Liu; Jinlong Zhao; Yong Yan; Jinping Su
Journal:  Medicine (Baltimore)       Date:  2019-03       Impact factor: 1.889

  2 in total

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