A prospective randomized comparative study to determine appropriate edoxaban administration period, to prevent deep vein thromboembolism in patients with total knee arthroplasty

J Orthop Sci. 2018 Nov;23(6):1005-1010. doi: 10.1016/j.jos.2018.06.004. Epub 2018 Jul 4.

Abstract

Background: This study aimed to determine the appropriate administration duration of edoxaban 15 mg (a factor Xa inhibitor) for the prevention of deep vein thrombosis (DVT) after total knee arthroplasty (TKA).

Methods: Our study comprised 202 patients who underwent TKA (excluding bilateral TKA) at our institution between 2014 and 2015. The subjects received edoxaban 15 mg daily for 1 (n = 93) or 2 (n = 109) weeks; group assignment was random. B-mode ultrasonography was performed 7 and 14 days post-TKA for the detection of DVT. We compared the incidence of DVT between the groups and examined for side effects.

Results: The demographic data of the patients in the 1- and 2-week administration groups were similar at baseline. DVT incidence did not differ significantly between the groups at 1 week post-TKA. However, it was significantly lower in the 2-week administration group (n = 0) than in the 1-week administration group (n = 7; p = 0.004) at 2 weeks post-DVT. Neither group exhibited symptomatic DVT. A total of six patients withdrew during the study period because of hepatic dysfunction.

Conclusions: Our results show that the administration of edoxaban 15 mg is more effective in preventing DVT after TKA when administered for 2 weeks than for 1 week.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthritis / diagnosis
  • Arthritis / etiology
  • Arthritis / surgery
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Drug Administration Schedule
  • Factor Xa Inhibitors / administration & dosage*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control*
  • Prospective Studies
  • Pyridines / administration & dosage*
  • Thiazoles / administration & dosage*
  • Venous Thromboembolism / epidemiology
  • Venous Thromboembolism / prevention & control*
  • Venous Thrombosis / epidemiology
  • Venous Thrombosis / prevention & control*

Substances

  • Factor Xa Inhibitors
  • Pyridines
  • Thiazoles
  • edoxaban