Seven kinds of new oral anticoagulants for prevention of venous thromboembolism after total hip or knee arthroplasty: a net Meta-analysis

YANG Jie; WEN Hua; MA Bing; SUN Jing

doi:10.3969/j.issn.1006-0111.2018.06.014

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Article Navigation > Journal of Pharmaceutical Practice and Service > 2018 > 36(6): 541-546

YANG Jie, WEN Hua, MA Bing, SUN Jing. Seven kinds of new oral anticoagulants for prevention of venous thromboembolism after total hip or knee arthroplasty: a net Meta-analysis[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(6): 541-546. doi: 10.3969/j.issn.1006-0111.2018.06.014

Citation:

YANG Jie, WEN Hua, MA Bing, SUN Jing. Seven kinds of new oral anticoagulants for prevention of venous thromboembolism after total hip or knee arthroplasty: a net Meta-analysis[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(6): 541-546. doi: 10.3969/j.issn.1006-0111.2018.06.014

Seven kinds of new oral anticoagulants for prevention of venous thromboembolism after total hip or knee arthroplasty: a net Meta-analysis

doi: 10.3969/j.issn.1006-0111.2018.06.014

1.
Department of Pneumology, The First Hospital, China Medical University, Shenyang 110001, China
2.
Department of Epidemiology, The First Hospital, China Medical University, Shenyang 110001, China
3.
Department of Dermatology, No. 463 Hospital of PLA, Shengyang 110042, China

Received Date: 2017-12-01
Rev Recd Date: 2018-08-25

Abstract

Objective To assess the efficacy of seven kinds of new oral anticoagulants in prevention of venous thromboembolism in patients after total hip or knee replacement by a network Meta-analysis. Methods Randomized clinical trials in databases of CBM,Cochrane Library,Pubmed were searched. The quality of the included studies was assessed. Data were analyzed by Stata12.0 software,and mvmeta program package. Results 24 RCTs (in all 1 091 articles,40 001 patients) met the criteria. Prevention for VTE with prescribed dosage was evaluated. Following findings,directly,Rivaroxaban and Apixaban were more effective than low molecular weight heparin,results as (RR=0.56,95%CI:0.40-0.78),P<0.05;(RR=0.39,95%CI:0.24-0.63),P<0.05. The others compared with LMWH,P>0.05,had no statistical significance. Indirectly,these were all superior efficacy to placebo. Conclusion Grade rankings of efficacy for seven kinds of NOACs prevented VTE in patients after THR or TKR,Apixaban was best,followed by Rivaroxaban,Edoxaban,Ym150,TAK-442,dabigatran etexilate,Betrixaban.
- new oral anticoagulants,
- total hip or knee replacement,
- venous thromboembolism,
- network Meta-analysis

References

[1]	吴丹辰,贾镭,徐希奇,等.新型口服抗凝药物预防及治疗静脉血栓栓塞症研究进展[J].中华关节外科杂志[J/OL],2013,7(3):420.
[2]	邱贵兴.中国骨科大手术静脉血栓栓塞症预防指南[J].中华关节外科杂志[J/OL],2009,3(3):380.
[3]	张超,陶华,李胜,等.应用Stata软件mvmeta程序包实现网状Meta分析[J].Chin J Evid-based Med,2014,14(9):1150-1159.
[4]	ERIKSSON B,DNHL OE,ROSENEHER N,et al.Dabigatran etexilate for prevention of venous thromboembolism after total hip replacement a randomised double-blin non-inferiority trial[J].Lancet,2007,370(9591):949-956.
[5]	ERIKSSON BI,DAHL OE,HUO MH,et al.Oral dabigatran versus enoxaparin for thromboprophylaxis after primary total hip arthroplasty[J].Thromb Haemost,2011,105(4):721-729.
[6]	ERIKSSON B,DNHL OE,ROEENCHER N,et al.Oral dabigatran etexilate and subctltalleous enoxparin for the prevention of veneous thromboembolism after total knee replacement the RE-MODEL randomized trial[J].J Thromb Haemost,2007,5(11):2178-2185.
[7]	GINSBERG JS,DAVIDSON BL,COMP PC,et al.Oral thrombin inhibitor or dabigatan etexilate and North Ameriean enoxaparin regimen for prevention of venous thrombomembolism after knee arthroplasty surgery[J].J Arthroplasty,2009,24(1):1-9.
[8]	ERIKSSON BI,BORRIS LC,FRIEDMAN RJ,et al.Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty[J].N Engl J Med,2008,358(26):2765-2775.
[9]	KAKKAR AK,BRENNER B,DAHL OE,et al.Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty:a double-blind,randomised controlled trial[J].Lancet,2008,372(9632):31-39.
[10]	LASSEN MR,AGENO W,BORRIS LC,et al.Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty[J].N Engl J Med,2008,358(26):2776-2786.
[11]	TURPIE AG,LASSEN MR,DAVIDSON BL,et al.Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4) a randomised trial[J].Lancet,2009,373(9676):1673-1680.
[12]	ERIKSSON BI,BORRIS L,DAHL OE,et al.For the ODIXa-HIP investigators study a randomised trial:a once-daily oral direct factor Xa inhibitor rivaroxaban (BAY 59-7939) for thromboprophylaxis after total hip replacement[J]. Circulation,2006,114(22):2374-2381.
[13]	ERIKSSON BI,BORRIS L,DAHL OE,et al.For the ODIXa-HIP investigators study a randomised trial:oral direct factor Xa inhibition with BAY 59-7939 for the prevention of venous thromboembolism after total hip replacement[J]. Thromb Haemost,2006,4:121-128.
[14]	TURPIE, FISHER, BAUER,et al.BAY 59-7939 an oral direct factor Xa inhibitor for the prevention of venous thromboembolism in patients after total knee replacement a phase Ⅱ dose-ranging study[J].Thromb Haemost,2005,3(11):2479-2486.
[15]	ERIKSSON BI,BORRIS LC,DAHL OE,et al.Dose-escalation study of rivaroxaban(BAY 59-7939) an oral direct factor Xa inhibitor-for the prevention of venous thromboembolism in patients undergoing total hip replacement[J].Thromb Res,2007,120(5):685-693.
[16]	LASSEN MR,DAVIDSON BL,GALLUS A,et al.The efficacy and safety of apixaban an oral direct factor Xa inhibitor as thromboprophylaxis in patients following total knee replacement[J].J Thromb Haemost,2007,5(12):2368-2375.
[17]	LASSEN MR,RASKOB GE,GALLUS A,et al.Apixaban or enoxaparin for thromboprophylaxis after knee replacement[J].N Engl J Med,2009,361(6):594-604.
[18]	LASSEN MR,RASKOB GE,GALLUS A,et al.Apixaban versus enoxaparin for thromboprophylaxis after knee replacement a randomised double-blind trial[J].Lancet,2010,375(9717):807-815.
[19]	LASSEN MR,GALLUS A,RASKOB GE,et al.Apixaban versus enoxaparin for thromboprophylaxis after hip replacement[J].N Engl J Med,2010,363(26):2487-2498.
[20]	FUJI T,FUJITA S,TACHIBANA S,et al.A dose-ranging study evaluating the oral factor Ⅹa inhibitor edoxaban for the prevention of venous thromboembolism in patients undergoing total knee arthroplasty[J].J Thromb Haemost,2010,8(11):2458-2468.
[21]	FUJI T,FUJITA S,KAWAI Y,et al.Efficacy and safety of edoxaban versus enoxaparin for the prevention of venous thromboembolism following total hip arthroplasty:STARS J-V[J].Thromb J,2015,13:27.
[22]	RASKOB G,COHEN AT,ERIKSSON BI,et al.Oral direct factor Xa inhibition with edoxaban for thromboprophylaxis after elective total hip replacement.a randomised double-blind dose-response study[J].Thromb Haemost,2010,104(3):642-649.
[23]	TURPIE AG,BAUER KA,DAVIDSON BL,et al. A randomized evaluation of betrixaban an oral factor Xa inhibitor for prevention of thromboembolic events after total knee replacement[J].Thromb Haemost,2009,101(1):68-76.
[24]	WEITZ JI,CAO C,ERIKSSON BI,et al.A dose-finding study with TAK-442 an oral factor Xa inhibitor in patients undergoing elective total knee replacement surgery[J].Thromb Haemost,2010,104(6):1150-1157.
[25]	ERIKSSON BI,TURPIE AG,LASSEN MR,et al.Prevention of venous thromboembolism with an oral factor Xa inhibitor YM150 after total hip arthroplasty a dose finding study (ONYX-2)[J].Journal of Thrombosis and Haemostasis,2010,8:714-721.
[26]	FUJI T,NAKAMURA M,TAKEUCHI M.Darexaban for the prevention of venous thromboembolism in Asian patients undergoing orthopedic surgery results from 2 randomized placebo-controlled,double-blind studies[J].Clinical and Applied Thrombosis Hemostasis,2014,20(2):199-211.
[27]	ERIKSSON BI,AGNELLI G,GALLUS AS,et al.Darexaban (YM150) versus enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty a randomised phase Ⅱb dose confirmation study (ONYX-3)[J].Thromb Haemost,2014,111(2):213-225.
[28]	STEVENSON M,SCOPE A,HOLMES M,et al.Rivaroxaban for the prevention of venous thromboembolism a single technology appraisal[J].Health Technol Assess,2009,13:43-48.
[29]	GOMEZ-OUTESA,TERLEIRA-FERNANDEZ AI,SUAREZ-GEA ML,et al.Dabigatran rivaroxaban or apixaban versus enoxaparin for thromboprophylaxis after total hip or knee replacement systematic review meta-analysis,and indirect treatment comparisons[J].BMJ,2012,344(14):3675.

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通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

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Seven kinds of new oral anticoagulants for prevention of venous thromboembolism after total hip or knee arthroplasty: a net Meta-analysis

1. Department of Pneumology, The First Hospital, China Medical University, Shenyang 110001, China

2. Department of Epidemiology, The First Hospital, China Medical University, Shenyang 110001, China

3. Department of Dermatology, No. 463 Hospital of PLA, Shengyang 110042, China

Received Date: 2017-12-01

Rev Recd Date: 2018-08-25

Key words:

Abstract: Objective To assess the efficacy of seven kinds of new oral anticoagulants in prevention of venous thromboembolism in patients after total hip or knee replacement by a network Meta-analysis. Methods Randomized clinical trials in databases of CBM,Cochrane Library,Pubmed were searched. The quality of the included studies was assessed. Data were analyzed by Stata12.0 software,and mvmeta program package. Results 24 RCTs (in all 1 091 articles,40 001 patients) met the criteria. Prevention for VTE with prescribed dosage was evaluated. Following findings,directly,Rivaroxaban and Apixaban were more effective than low molecular weight heparin,results as (RR=0.56,95%CI:0.40-0.78),P<0.05;(RR=0.39,95%CI:0.24-0.63),P<0.05. The others compared with LMWH,P>0.05,had no statistical significance. Indirectly,these were all superior efficacy to placebo. Conclusion Grade rankings of efficacy for seven kinds of NOACs prevented VTE in patients after THR or TKR,Apixaban was best,followed by Rivaroxaban,Edoxaban,Ym150,TAK-442,dabigatran etexilate,Betrixaban.

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Reference (29)

[1]	吴丹辰,贾镭,徐希奇,等.新型口服抗凝药物预防及治疗静脉血栓栓塞症研究进展[J].中华关节外科杂志[J/OL],2013,7(3):420.
[2]	邱贵兴.中国骨科大手术静脉血栓栓塞症预防指南[J].中华关节外科杂志[J/OL],2009,3(3):380.
[3]	张超,陶华,李胜,等.应用Stata软件mvmeta程序包实现网状Meta分析[J].Chin J Evid-based Med,2014,14(9):1150-1159.
[4]	ERIKSSON B,DNHL OE,ROSENEHER N,et al.Dabigatran etexilate for prevention of venous thromboembolism after total hip replacement a randomised double-blin non-inferiority trial[J].Lancet,2007,370(9591):949-956.
[5]	ERIKSSON BI,DAHL OE,HUO MH,et al.Oral dabigatran versus enoxaparin for thromboprophylaxis after primary total hip arthroplasty[J].Thromb Haemost,2011,105(4):721-729.
[6]	ERIKSSON B,DNHL OE,ROEENCHER N,et al.Oral dabigatran etexilate and subctltalleous enoxparin for the prevention of veneous thromboembolism after total knee replacement the RE-MODEL randomized trial[J].J Thromb Haemost,2007,5(11):2178-2185.
[7]	GINSBERG JS,DAVIDSON BL,COMP PC,et al.Oral thrombin inhibitor or dabigatan etexilate and North Ameriean enoxaparin regimen for prevention of venous thrombomembolism after knee arthroplasty surgery[J].J Arthroplasty,2009,24(1):1-9.
[8]	ERIKSSON BI,BORRIS LC,FRIEDMAN RJ,et al.Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty[J].N Engl J Med,2008,358(26):2765-2775.
[9]	KAKKAR AK,BRENNER B,DAHL OE,et al.Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty:a double-blind,randomised controlled trial[J].Lancet,2008,372(9632):31-39.
[10]	LASSEN MR,AGENO W,BORRIS LC,et al.Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty[J].N Engl J Med,2008,358(26):2776-2786.
[11]	TURPIE AG,LASSEN MR,DAVIDSON BL,et al.Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4) a randomised trial[J].Lancet,2009,373(9676):1673-1680.
[12]	ERIKSSON BI,BORRIS L,DAHL OE,et al.For the ODIXa-HIP investigators study a randomised trial:a once-daily oral direct factor Xa inhibitor rivaroxaban (BAY 59-7939) for thromboprophylaxis after total hip replacement[J]. Circulation,2006,114(22):2374-2381.
[13]	ERIKSSON BI,BORRIS L,DAHL OE,et al.For the ODIXa-HIP investigators study a randomised trial:oral direct factor Xa inhibition with BAY 59-7939 for the prevention of venous thromboembolism after total hip replacement[J]. Thromb Haemost,2006,4:121-128.
[14]	TURPIE, FISHER, BAUER,et al.BAY 59-7939 an oral direct factor Xa inhibitor for the prevention of venous thromboembolism in patients after total knee replacement a phase Ⅱ dose-ranging study[J].Thromb Haemost,2005,3(11):2479-2486.
[15]	ERIKSSON BI,BORRIS LC,DAHL OE,et al.Dose-escalation study of rivaroxaban(BAY 59-7939) an oral direct factor Xa inhibitor-for the prevention of venous thromboembolism in patients undergoing total hip replacement[J].Thromb Res,2007,120(5):685-693.
[16]	LASSEN MR,DAVIDSON BL,GALLUS A,et al.The efficacy and safety of apixaban an oral direct factor Xa inhibitor as thromboprophylaxis in patients following total knee replacement[J].J Thromb Haemost,2007,5(12):2368-2375.
[17]	LASSEN MR,RASKOB GE,GALLUS A,et al.Apixaban or enoxaparin for thromboprophylaxis after knee replacement[J].N Engl J Med,2009,361(6):594-604.
[18]	LASSEN MR,RASKOB GE,GALLUS A,et al.Apixaban versus enoxaparin for thromboprophylaxis after knee replacement a randomised double-blind trial[J].Lancet,2010,375(9717):807-815.
[19]	LASSEN MR,GALLUS A,RASKOB GE,et al.Apixaban versus enoxaparin for thromboprophylaxis after hip replacement[J].N Engl J Med,2010,363(26):2487-2498.
[20]	FUJI T,FUJITA S,TACHIBANA S,et al.A dose-ranging study evaluating the oral factor Ⅹa inhibitor edoxaban for the prevention of venous thromboembolism in patients undergoing total knee arthroplasty[J].J Thromb Haemost,2010,8(11):2458-2468.
[21]	FUJI T,FUJITA S,KAWAI Y,et al.Efficacy and safety of edoxaban versus enoxaparin for the prevention of venous thromboembolism following total hip arthroplasty:STARS J-V[J].Thromb J,2015,13:27.
[22]	RASKOB G,COHEN AT,ERIKSSON BI,et al.Oral direct factor Xa inhibition with edoxaban for thromboprophylaxis after elective total hip replacement.a randomised double-blind dose-response study[J].Thromb Haemost,2010,104(3):642-649.
[23]	TURPIE AG,BAUER KA,DAVIDSON BL,et al. A randomized evaluation of betrixaban an oral factor Xa inhibitor for prevention of thromboembolic events after total knee replacement[J].Thromb Haemost,2009,101(1):68-76.
[24]	WEITZ JI,CAO C,ERIKSSON BI,et al.A dose-finding study with TAK-442 an oral factor Xa inhibitor in patients undergoing elective total knee replacement surgery[J].Thromb Haemost,2010,104(6):1150-1157.
[25]	ERIKSSON BI,TURPIE AG,LASSEN MR,et al.Prevention of venous thromboembolism with an oral factor Xa inhibitor YM150 after total hip arthroplasty a dose finding study (ONYX-2)[J].Journal of Thrombosis and Haemostasis,2010,8:714-721.
[26]	FUJI T,NAKAMURA M,TAKEUCHI M.Darexaban for the prevention of venous thromboembolism in Asian patients undergoing orthopedic surgery results from 2 randomized placebo-controlled,double-blind studies[J].Clinical and Applied Thrombosis Hemostasis,2014,20(2):199-211.
[27]	ERIKSSON BI,AGNELLI G,GALLUS AS,et al.Darexaban (YM150) versus enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty a randomised phase Ⅱb dose confirmation study (ONYX-3)[J].Thromb Haemost,2014,111(2):213-225.
[28]	STEVENSON M,SCOPE A,HOLMES M,et al.Rivaroxaban for the prevention of venous thromboembolism a single technology appraisal[J].Health Technol Assess,2009,13:43-48.
[29]	GOMEZ-OUTESA,TERLEIRA-FERNANDEZ AI,SUAREZ-GEA ML,et al.Dabigatran rivaroxaban or apixaban versus enoxaparin for thromboprophylaxis after total hip or knee replacement systematic review meta-analysis,and indirect treatment comparisons[J].BMJ,2012,344(14):3675.

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Seven kinds of new oral anticoagulants for prevention of venous thromboembolism after total hip or knee arthroplasty: a net Meta-analysis

doi: 10.3969/j.issn.1006-0111.2018.06.014

Abstract

References

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通讯作者: 陈斌, bchen63@163.com

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