Abstract
Objective: Prevention of venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), is one of the most important clinical interventions after total hip arthroplasty (THA), which is a procedure associated with a high risk for VTE. We aimed to test the efficacy and safety of oral edoxaban, a factor Xa inbitor, for the prevention of VTE after THA in comparison to enoxaparin.
Methods: Following THA, 42 patients received either edoxaban or enoxaparin for VTE prophylaxis. There were a total of 8 males and 34 females, with an average age of 67.0 years old. This was a retrospective, non-randomised, and non-blinded study. The first 23 patients received subcutaneous enoxaparin 2000 IU every 12 hours for 10 days, starting 3 days after surgery. The following 19 patients received oral edoxaban 30 mg once daily for 7 days, starting 3 days after surgery. On days 1, 7, 14, and 28 following surgery, D-Dimer levels were compared. VTE events and bleeding events were recorded for up to 3 months.
Results: On day 1, D-Dimer level was 9.8±1.9 in patients given enoxaparin and 10.5±1.7 in patients given edoxaban (P = 0.8602). On day 7 following surgery, D-Dimer level was significantly lower in patients given edoxaban (7.0±0.7 vs 5.0±0.4), respectively, On day 14 following surgery, the difference still existed (7.2±0.7 vs 5.5±0.4, p < 0.05), but by day 28, there was no statistically significant difference between two groups (4.8±0.7 vs 3.8±0.5, P = 0.2627). No clinical VTE event or bleeding event occurred in this study.
Conclusion: Oral edoxaban 30 mg given once daily significantly suppressed the increase of D-Dimer levels in comparison with subcutaneous enoxaparin 2000 IU given every 12 hours. Bleeding was not observed in this study, and we therefore recommend that edoxaban is used for the prevention of VTE after THA.
