Efficacy and risks of fondaparinux 7.5 mg for deep vein thrombosis after total knee arthroplasty
Objectives: High-dose fondaparinux therapy at 7.5 mg/day (FPX 7.5 mg) for deep vein thrombosis (DVT) may increase the risk of hemorrhage. We investigated the efficacy and safety of FPX 7.5 mg to treat DVT after total knee arthroplasty. Methods: This study included 101 patients (91 with osteoarthriti...
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| Format: | Article |
| Language: | English |
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Fujita Medical Society
2019-02-01
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| Series: | Fujita Medical Journal |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/fmj/5/1/5_2017-020/_pdf/-char/en |
| _version_ | 1819135228772352000 |
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| author | Sho Nojiri Kazue Hayakawa Hideki Date Harumoto Yamada |
| author_facet | Sho Nojiri Kazue Hayakawa Hideki Date Harumoto Yamada |
| author_sort | Sho Nojiri |
| collection | DOAJ |
| description | Objectives: High-dose fondaparinux therapy at 7.5 mg/day (FPX 7.5 mg) for deep vein thrombosis (DVT) may increase the risk of hemorrhage. We investigated the efficacy and safety of FPX 7.5 mg to treat DVT after total knee arthroplasty. Methods: This study included 101 patients (91 with osteoarthritis, 10 with rheumatoid arthritis; mean age at total knee arthroplasty: 72.9 years) with asymptomatic postoperative DVT. Medical prophylaxis for DVT was started on postoperative day 1. Vascular ultrasound was conducted within 2 days postoperatively; patients were switched to FPX 7.5 mg after DVT diagnosis. Ultrasound was repeated to monitor DVT resolution. Adverse reactions were assessed. Results: DVT resolved in 72 patients (71.3%) receiving FPX 7.5 mg. There were no significant differences between patients with versus without DVT resolution in the timing of FPX 7.5 mg therapy, treatment period, age, body mass index, or D-dimer or hemoglobin levels. There was no significant difference in DVT outcome between patients starting FPX 7.5 mg within 4 days postoperatively versus on day 5 or later, or between patients treated for ≤7 versus ≥8 days. Hemoglobin decreased to ≤7 g/dL in three patients (2.9%). Conclusions: FPX 7.5 mg can be expected to resolve DVT in 71.3% of patients; however, the risk of associated hemorrhagic complications may be higher than the risk of pulmonary embolism. To treat DVT with FPX 7.5 mg without compromising safety, patients should be selected carefully and the timing of treatment should be adjusted appropriately. |
| first_indexed | 2024-12-22T10:15:45Z |
| format | Article |
| id | doaj.art-faa49a31b650433a8e50e165e0abbb84 |
| institution | Directory Open Access Journal |
| issn | 2189-7247 2189-7255 |
| language | English |
| last_indexed | 2024-12-22T10:15:45Z |
| publishDate | 2019-02-01 |
| publisher | Fujita Medical Society |
| record_format | Article |
| series | Fujita Medical Journal |
| spelling | doaj.art-faa49a31b650433a8e50e165e0abbb842022-12-21T18:29:44ZengFujita Medical SocietyFujita Medical Journal2189-72472189-72552019-02-015191310.20407/fmj.2017-020Efficacy and risks of fondaparinux 7.5 mg for deep vein thrombosis after total knee arthroplastySho NojiriKazue HayakawaHideki DateHarumoto YamadaObjectives: High-dose fondaparinux therapy at 7.5 mg/day (FPX 7.5 mg) for deep vein thrombosis (DVT) may increase the risk of hemorrhage. We investigated the efficacy and safety of FPX 7.5 mg to treat DVT after total knee arthroplasty. Methods: This study included 101 patients (91 with osteoarthritis, 10 with rheumatoid arthritis; mean age at total knee arthroplasty: 72.9 years) with asymptomatic postoperative DVT. Medical prophylaxis for DVT was started on postoperative day 1. Vascular ultrasound was conducted within 2 days postoperatively; patients were switched to FPX 7.5 mg after DVT diagnosis. Ultrasound was repeated to monitor DVT resolution. Adverse reactions were assessed. Results: DVT resolved in 72 patients (71.3%) receiving FPX 7.5 mg. There were no significant differences between patients with versus without DVT resolution in the timing of FPX 7.5 mg therapy, treatment period, age, body mass index, or D-dimer or hemoglobin levels. There was no significant difference in DVT outcome between patients starting FPX 7.5 mg within 4 days postoperatively versus on day 5 or later, or between patients treated for ≤7 versus ≥8 days. Hemoglobin decreased to ≤7 g/dL in three patients (2.9%). Conclusions: FPX 7.5 mg can be expected to resolve DVT in 71.3% of patients; however, the risk of associated hemorrhagic complications may be higher than the risk of pulmonary embolism. To treat DVT with FPX 7.5 mg without compromising safety, patients should be selected carefully and the timing of treatment should be adjusted appropriately.https://www.jstage.jst.go.jp/article/fmj/5/1/5_2017-020/_pdf/-char/endeep vein thrombosisfondaparinuxpulmonary thromboembolismtotal knee arthroplasty |
| spellingShingle | Sho Nojiri Kazue Hayakawa Hideki Date Harumoto Yamada Efficacy and risks of fondaparinux 7.5 mg for deep vein thrombosis after total knee arthroplasty Fujita Medical Journal deep vein thrombosis fondaparinux pulmonary thromboembolism total knee arthroplasty |
| title | Efficacy and risks of fondaparinux 7.5 mg for deep vein thrombosis after total knee arthroplasty |
| title_full | Efficacy and risks of fondaparinux 7.5 mg for deep vein thrombosis after total knee arthroplasty |
| title_fullStr | Efficacy and risks of fondaparinux 7.5 mg for deep vein thrombosis after total knee arthroplasty |
| title_full_unstemmed | Efficacy and risks of fondaparinux 7.5 mg for deep vein thrombosis after total knee arthroplasty |
| title_short | Efficacy and risks of fondaparinux 7.5 mg for deep vein thrombosis after total knee arthroplasty |
| title_sort | efficacy and risks of fondaparinux 7 5 mg for deep vein thrombosis after total knee arthroplasty |
| topic | deep vein thrombosis fondaparinux pulmonary thromboembolism total knee arthroplasty |
| url | https://www.jstage.jst.go.jp/article/fmj/5/1/5_2017-020/_pdf/-char/en |
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