Efficacy and Safety of Rivaroxaban versus Low Molecular Weight Heparin in the Prevention of Venous Thromboembolism in Patients with Hip Fracture ：A Meta-analysis
- VernacularTitle:利伐沙班对比低分子肝素预防髋骨骨折患者发生静脉血栓的有效性和安全性的Meta分析
- Author:
Liliang WANG
1
;
Jin JIN
1
;
Yang YANG
1
;
Zhengxiang LI
1
;
Hengjie YUAN
1
Author Information
1. Dept. of Pharmacy，General Hospital of Tianjin Medical Universit y，Tianjin 300052，China
- Publication Type:Journal Article
- Keywords:
Rivaroxaban;
Low molecular weight heparin;
Hip fracture;
Prevention;
Venous thromboembolism;
Meta-analysis
- From:
China Pharmacy
2019;30(1):120-124
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE： To systematically evaluate the efficacy and safety of rivaroxaban versus low molecular weight heparin in the prevention of venous thromboembolism （VTE） in patients with hip fractures， and to provide evidence-based reference for clinical application. METHODS： Retrieved from Cochrane library， PubMed， Embase， CNKI， VIP and Wanfang database， randomized controlled trials （RCTs） about rivaroxaban （test group） versus low molecular weight heparin （control group） in the prevention of VTE in patients with hip fracture were collected during database establishment to Jun. 2018. After data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0， Meta-analysis was performed by using Rev Man 5.3 statistical software for the incidence of deep venous thrombosis （DVT）， postoperative discharge， activated partial thromboplastin time （APTT）， prothrombin time （PT） and the incidence of ADR. RESULTS： Totally 8 RCTs were included， involving 949 patients. Results of Meta-analysis showed that compared with low molecular weight heparin， rivaroxaban could significantly decreased the incidence of DVT [RR＝0.55， 95％CI （0.36， 0.83）， P＝0.004]. There was no statistical significance in postoperative discharge [MD＝－0.24， 95％CI （－5.27， 4.8）， P＝0.93]， APTT [MD=0.56， 95％CI （－0.75， 1.86）， P＝0.40]， PT [MD＝0.04， 95％CI（－0.03， 0.11）， P＝0.25] or the incidence of ADR [RR=1.73，95％CI（0.15，20.48）， P＝0.66] between 2 groups. CONCLUSIONS： Rivaroxaban has a better preventive effect on VTE in patients with hip fracture than low molecular weight heparin， and has a similar safety as low molecular weight heparin.
