Oral factor Xa inhibitors are attractive options for preventing post-op thromboembolic disease, since they are given at a fixed dose and do not require serum monitoring. In this randomized trial, 3195 post-op total knee replacement patients were randomized to apixaban (2.5mg po BID) or enoxaparin (30mg SQ BID) for 10-14 days. The primary outcome (DVT, PE, or death) occurred in 9% in each group, with less bleeding in the apixaban group (3% vs 4%). Apixaban is a promising new oral agent for post-op thromboembolism prevention, pending FDA approval (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.