Rivaroxaban Versus Enoxaparin For Prevention Of Deep Venous Thrombosis After Major Orthopedic Operation: A Systematic Review

Objective:To assess the efficacy and safety of rivaroxaban versus enoxaparin in prevention of deep venous thrombosis after major orthopedic operation. Methods:We searched MEDLINE (1966 to December 2010), EMBASE (1974 to December 2010), The Cochrane Library (Issue 3,2010), Current Controlled Trials, The National Research Register, CBM (1983 to December 2010) and CNK1 (1994 to December 2010). Some related journals were hand searched as well. The quality of included randomized controlled trials was evaluated and meta-analysis was conducted by The Cochrane Collaboration's software RevMan 5.0.25. Results:rivaroxaban compared with enoxaparin could reducing the risk of the primary outcome (RR=0.40,95%CI: 0.28-0.57, P<0.00001) and reduce the risk of The main secondary efficacy outcome (RR =0.26,95%CI:0.18-0.37, P<0.00001),also reduce the risk for other efficacy outcomes(RR= 0.47,95%CI:0.38-0.57, P<0.00001), rivaroxaban significantly better than enoxaparin. During treatment the incidence of serious bleeding events similarly(RR =1.19,95%CI:0.71-1.98, P=0.51),the secondary safety endpoint were similar in the control group. Conclusion:rivaroxaban is effective in prevention of deep venous thrombosis after major orthopedic operation, which significantly reduce the risk of postoperative deep vein thrombosis...