Selective Factor Xa Inhibition Improves Efficacy of Venous Thromboembolism Prophylaxis in Orthopedic Surgery

Philip C. Comp, M.D., Ph.D.


Pharmacotherapy. 2003;23(6) 

In This Article


Despite the reduced rate of venous thromboembolism that thromboprophylactic agents afford compared with no prophylaxis, residual DVT rates remain unacceptably high even with the best agent for a given indication. This is particularly so in patients undergoing major hip and knee surgeries -- populations at high risk for thromboembolic complications. The search for new antithrombotic agents that have greater safety and efficacy in preventing venous thromboembolism in these indications has focused on the development of drugs that target individual components of the coagulation process, with major targets being thrombin and factor Xa. Collective efficacy data for DVT prevention in historic, as well as more recent, clinical trials of venous thromboembolism prophylaxis in major orthopedic surgery suggest that agents with increasing selectivity for factor Xa inhibition may provide greater clinical benefit. Additional evidence-based findings will establish the true potential of the various emerging antithrombotic therapies for improving the management of venous thrombotic complications in high-risk major orthopedic surgery populations.


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