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Jan Steffel, Thomas F Lüscher. Journal of Cardiovascular Medicine Community Oncology 6 , Becker, David Garcia, Elaine M. Nicolau, Ari Timmerman, Ana T. Terry Chen, Sum Lam. Cardiology in Review 17 , British Journal of Hospital Medicine Anticoagulants for the Treatment ofVenous Thromboembolism. New Therapeutic Agents in Thrombosis and Thrombolysis, Oral Direct Factor Xa Inhibitors. Expert Review of Cardiovascular Therapy 7 , A subanalysis of two pooled randomized trials. European Journal of Haematology Catherine Rea, Beverley J Hunt. Douglas Elwood, Caroline Koo. Risks and Benefits of Anticoagulation. Archives of Cardiovascular Diseases , Pharmacotherapy 29 , Evidence-Based Practice of Anesthesiology, Updates on clinical trial. Japanese Journal of Thrombosis and Hemostasis 20 , Annual Reports in Medicinal Chemistry Volume 44, Annales de Dermatologie et de Vénéréologie , SS The current and future use of novel anticoagulants. Clinics in Geriatric Medicine Nature Clinical Practice Rheumatology 4 , Neurosurgery 63 , NN Hospital Pharmacy 43 , Mechanisms underlying emerging agents. Canadian Journal of Cardiology 24 , 56CC. Reviews in Clinical Gerontology 18 , Lohrmann , Jens , Becker , Richard C. See related Challenge and other articles in the series. The New England Journal of Medicine. The narration and closed captions in this video are in English. The scientific reports by Hwang et al. See Snyder and Loring for further information. The scientific report by Hwang et al. Adobe Flash Player is required to view this feature. If you are using an operating system that does not support Flash, we are working to bring you alternative formats. Background We investigated the efficacy of rivaroxaban, an orally active direct factor Xa inhibitor, in preventing venous thrombosis after total knee arthroplasty. Methods In this randomized, double-blind trial, patients who were to undergo total knee arthroplasty received either oral rivaroxaban, 10 mg once daily, beginning 6 to 8 hours after surgery, or subcutaneous enoxaparin, 40 mg once daily, beginning 12 hours before surgery. Results The primary efficacy outcome occurred in 79 of patients 9. Conclusions Rivaroxaban was superior to enoxaparin for thromboprophylaxis after total knee arthroplasty, with similar rates of bleeding. Article Activity articles have cited this article. Methods Patients Patients were eligible for the study if they were 18 years of age or older and were scheduled for total knee arthroplasty. Study Design and Medications On a double-blind and double-dummy basis, before surgery, patients were randomly assigned through a central telephone system to receive once-daily oral rivaroxaban Bayer HealthCare , in a mg tablet, or a once-daily injection of enoxaparin sodium Clexane or Lovenox, Sanofi-Aventis , in a mg dose. Outcome Measures All outcomes were assessed by central, independent adjudication committees who were unaware of the treatment assignments. Statistical Analysis We aimed to determine whether the efficacy of rivaroxaban was noninferior to that of enoxaparin in the per-protocol population and, if so, to determine whether rivaroxaban had superior efficacy to enoxaparin in the modified intention-to-treat population. Efficacy Outcomes The primary efficacy outcome occurred in 79 of patients 9. Safety Major bleeding occurred in 7 of patients 0. Discussion In this trial of thromboprophylaxis after total knee arthroplasty, we found that rivaroxaban, an orally active direct inhibitor of factor Xa, was more effective than enoxaparin in preventing venous thrombosis, with similar rates of bleeding. No other potential conflict of interest relevant to this article was reported. CrossRef 5 Mark P. CrossRef 10 Jay R. CrossRef 12 Corey S. CrossRef 15 Anjan Talukdar, S. CrossRef 19 Louis M. 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