HealthDay News — For patients who have undergone total hip or knee arthroplasty, extended prophylaxis with aspirin does not differ significantly from rivaroxaban for venous thromboembolism prevention, according to a study published in the New England Journal of Medicine.
David R. Anderson, MD, from Dalhousie University in Halifax, Canada, and colleagues conducted a multicenter randomized trial involving patients who were undergoing total hip (1804 patients) or knee (1620 patients) arthroplasty. All patients received oral rivaroxaban until postoperative day 5 and were then randomly assigned to continue rivaroxaban or switch to aspirin for 9 or 30 days after total knee or total hip arthroplasty, respectively. Patients were followed for 90 days.
The researchers found that venous thromboembolism occurred in 0.64% and 0.7% of patients in the aspirin and rivaroxaban groups, respectively (difference, 0.06 percentage points; 95% CI, −0.55 to 0.66; P < .001 for noninferiority and P = .84 for superiority).
Major bleeding complications occurred in 0.47% and 0.29% of patients in the aspirin and rivaroxaban groups, respectively (difference, 0.18 percentage points; 95% CI, −0.65 to 0.29; P =.42). Clinically important bleeding occurred in 1.29% and 0.99% of patients in the aspirin and rivaroxaban groups, respectively (difference, 0.3 percentage points; 95% CI, −1.07 to 0.47; P = .43).
“Extended prophylaxis with aspirin was not significantly different from rivaroxaban in the prevention of symptomatic venous thromboembolism,” the authors wrote.
Disclosures: Several authors disclosed financial ties to the pharmaceutical industry.
Anderson DR, Dunbar M, Murnaghan J, et al. Aspirin or rivaroxaban for VTE prophylaxis after hip or knee arthroplasty [published online February 22, 2018. N Engl J Med. doi:10.1056/NEJMoa1712746