Economic Impact of Venous Thromboembolism After Hip and Knee Arthroplasty

Potential Impact of Rivaroxaban

Richard J Friedman; Nishan Sengupta; Michael Lees

Disclosures

Expert Rev Pharmacoeconomics Outcomes Res. 2011;11(3):299-306. 

In This Article

Drawbacks of Established Anticoagulants

Although LMWHs[7] are safe and effective as anticoagulants after THA[8] and TKA,[9] they require subcutaneous (sc.) administration.[7] Fondaparinux, a synthetic pentasaccharide that inhibits thrombin generation by binding to anti-thrombin and selectively inhibiting factor Xa, also needs sc. administration.[10,11] Warfarin has the advantage of oral administration, but has a narrow therapeutic window with unpredictable pharmacokinetics and pharmacodynamics, which are affected by genetic factors, drug–drug interactions and foods containing vitamin K.[12] Regular coagulation monitoring and dose adjustment of warfarin is required to ensure optimal anticoagulation (to maintain the international normalized ratio at 2–3).[12]

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