Apixaban for the prevention of thromboembolism in adults after elective hip or knee replacement surgery, and in symptomatic venous thromboembolism

Doggrell, Sheila (2012) Apixaban for the prevention of thromboembolism in adults after elective hip or knee replacement surgery, and in symptomatic venous thromboembolism. Clinical Medicine Reviews in Vascular Health, 4, pp. 19-28.

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The anticoagulant effect of apixaban is due to direct inhibition of FXa in the coagulation cascade. The main advantages apixaban has over the current anti-coagulant drugs is that it is active after oral administration, and its coagulation effect does not require monitoring. Apixaban has been compared to enoxaparin in the prevention of venous thromboembolism associated with knee and hip replacement, where it is as efficacious as enoxaparin, but causes less bleeding. However, apixaban is not the only FXa inhibitor that could replace enoxaparin for this indication, as the FXa inhibitor rivaroxaban is as efficacious and safe as enoxaparin in preventing thromboembolism associated with these surgical procedures. Until the results of the AMPLIFY Phase III trial are known, it is too early to consider apixaban as an alternative to enoxaparin in symptomatic thromboembolism. Apixaban should not be used to prevent thromboembolism in medical immobilised subjects or acute coronary syndromes, as it causes excess bleeding in these conditions without benefit.

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ID Code: 54565
Item Type: Review
Refereed: Yes
Keywords: apixaban, thromboembolism, elective knee and hip replacement
DOI: 10.4137/CMRVH.S7280
ISSN: 1179-2566
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PHARMACOLOGY AND PHARMACEUTICAL SCIENCES (111500)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Deposited On: 05 Nov 2012 02:46
Last Modified: 23 May 2013 04:44

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