Thromboprophylaxis with dabigatran after total hip arthroplasty in Indian patients: A subanalysis of a double-blind, double-dummy, randomized RE-NOVATE II study

作者：Rajesh Malhotra, Sushrut Babhulkar, Kumar Behera Sanjib, Andreas Clemens, Akhil Dadi, Rajagopalan Iyer, Surendra U. Kamath, Bharat Mody, Satish Mutha, G Nikhitha Reddy, Vikram Shah, Vrajesh J. Shah, Naresh Shetty, Sachin Tapasvi, Manuj Wadhwa · 发表于：Asian Journal of Surgery · 年份：2016 · DOI：10.1016/j.asjsur.2015.10.007 · 被引用次数：7 · 研究领域：Atrial Fibrillation Management and Outcomes、Venous Thromboembolism Diagnosis and Management、Heparin-Induced Thrombocytopenia and Thrombosis

OBJECTIVE: In the Re-NOVATE II study, oral dabigatran provided thromboprophylaxis after total hip arthroplasty and improved compliance postdischarge in a global population. This article aims to identify trends (if any) in the Indian population. METHODS: In this prospective, double-blind, double-dummy study, patients scheduled for primary, unilateral, elective total hip arthroplasty were randomized to 220 mg oral dabigatran once daily, starting with a 110 mg half-dose, 1-4 hours after surgery, or subcutaneous enoxaparin 40 mg once daily, starting the evening before surgery. Each group received a placebo of the other study drug. The primary efficacy outcome was the composite of total venous thromboembolism (VTE) and all-cause mortality. Secondary outcome measures were composite of major VTE and VTE-related mortality during the treatment period. The major safety outcome was incidence of bleeding events. RESULTS: Of the 179 Indian patients randomized, 91 received oral dabigatran and 88 received subcutaneous enoxaparin for 28-35 days. Total VTE and all-cause mortality occurred in 18.7% of patients in the dabigatran group and 13.7% in the enoxaparin group [odds ratio = 1.4 (95% confidence interval 0.6, 3.5)]. Major VTE and VTE-related mortality was numerically lower in the dabigatran group (7.9%) compared with the enoxaparin group (9.9%). Safety outcomes were comparable between both groups. CONCLUSION: Dabigatran is an effective oral alternative to enoxaparin for thromboprophylaxis...