The FDA has approved rivaroxaban (Xarelto – Janssen), an oral direct factor Xa inhibitor, for prevention of deep vein thrombosis (DVT) in patients undergoing knee or hip replacement surgery.

CLINICAL STUDIES — A pooled analysis of four randomized, double-blind trials (the RECORD studies1-4) in a total of 12,729 patients undergoing hip or knee arthroplasty found that a composite endpoint of symptomatic venous thromboembolism (VTE) or death occurred in 0.5% of patients taking rivaroxaban 10 mg once daily and in 1% of patients taking the low-molecular weight heparin enoxaparin 40 mg once or 30 mg twice daily, a significant difference. Major bleeding occurred in 0.3% of patients treated with rivaroxaban and in 0.2% of those receiving enoxaparin. Major plus non-major clinically relevant bleeding occurred in 2.8% vs. 2.5%, and any bleeding occurred in 6.6% vs. 6.2%. None ... more      

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