Efficacy of Direct Oral Anticoagulants for the Treatment of Deep Vein Thrombosis in Orthopedic Perioperative Patients

Abstract

This study compared the efficacy of warfarin with three types of direct oral anticoagulants (DOAC) for the treatment of deep vein thrombosis (DVT) in patients who underwent orthopedic surgery. Three hundred and five DVT cases were included in this study. The thrombus resolution rates were 64.4%, 81.3%, 94.6%, and 94.8% and the number of days until thrombus resolution were 44.8, 22.2, 17.7 and 16.8 in each group (warfarin, edoxaban, rivaroxaban, apixaban). The results indicated that each of the DOACs, as compared to warfarin, showed superior efficacy in achieving thrombus resolution. Among the DOACs, rivaroxaban and apixaban which are safe to use with double-dose treatment, indicated good results. One patient in the group receiving rivaroxaban experienced intra-articular bleeding, which resolved after drainage. No patients in the other groups developed clinically significant bleeding. This study shows that DOACs, as compared to warfarin, have superior efficacy for the treatment of DVT in patients who underwent orthopedic surgery.