International Journal of Pharmacology 1811-7775 1812-5700 Asian Network for Scientific Information 10.3923/ijp.2018.1.8 Jiang Shilin Du Liang Ni Cheng 1 2018 14 1 Background and Objective: Many anticoagulants have significant drawbacks: Aspirin has limited efficacy, warfarin is highly effective but the dosage must be monitored and adjusted carefully and dabigatran is effective but may be lethal. The current study compares the efficacy of rivaroxaban, low-dose nadroparin calcium and high-dose nadroparin calcium for thromboprophylaxis in patients after total hip replacement (THR) surgery. Materials and Methods: A total of 831 THR surgery patients were enrolled in this randomized, three-arm study (n = 277 for each of three groups). Group I patients received rivaroxaban (10 mg), group II patients received low-dose nadroparin calcium (3,000 anti-Xa IU kg–1 b.wt.) and group III patients received high-dose nadroparin calcium (6,500 anti-Xa IU kg–1 b.wt.). Follow-up visits with patients were conducted 40 days after the intervention. Outcomes were measured using D-dimer test assays, angiography and digital color Doppler scanner ultrasound. Additionally, the cost of treatment was calculated for each patient. A two-tailed paired t-test and Dunnett’s multiple comparison tests were used to compare measured outcomes and the cost of therapy between groups I and II and between groups I and III at a 95% confidence level. Results: Efficacy outcomes for group I were superior to those of group II (p<0.05 for all outcomes) and comparable to those of group III (p>0.05 for all outcomes). The 10 mg rivaroxaban treatment had a major bleeding event in the gastrointestinal tract and liver. Adverse effects of nadroparin included hyperkalemia, skin rash and leg weakness. The cost of therapy was highest for group III and lowest for group I. Conclusion: Rivaroxaban and nadroparin are both effective as thromboprophylactic drugs in patients following THR surgery and have few adverse effects. Physicians may successfully use any of these therapies according to the patient’s condition.

]]> Al-Horani, R.A. and U.R. Desai, 2016 Expert Opin. Ther. Patents, 26 323 345 Malhotra, R., S. Babhulkar, K.B. Sanjib, A. Clemens and A. Dadi et al., 2017 Asian J. Surg., 40 145 151 Garcia-Olivares, P., J.E. Guerrero, E. Keough, P. Galdos and D. Carriedo et al., 2016 Thrombosis Res., 143 111 117 Patel, M.R., K.W. Mahaffey, J. Garg, G. Pan and D.E. Singer et al., 2011 N. Eng. J. Med., 365 883 891 Mommsen, P., M. Doering, C. Egidy, T. Gehrke, C. Krettek and D. Kendoff, 2014 Technol. Health Care, 22 901 908 Stewart, D.W. and J.E. Freshour, 2013 Ann. Pharm., 47 63 74 Ventura, F., A. Bonsignore, F. De Stefano, E. Pizzorno and C. Palmiere, 2014 Forensic Sci. Med. Pathol., 10 619 622 Weitz, J.I., A.W. Lensing, M.H. Prins, R. Bauersachs and J. Beyer-Westendorf et al., 2017 N. Engl. J. Med., 376 1211 1222 Karlberg, J.P.E. and M.A. Speers, 2010 Reviewing Clinical Trials: A Guide for the Ethics Committee. Pages: 153 Pages: 153 Charan, J. and T. Biswas, 2013 Indian J. Psychol. Med., 35 121 126 Min, S.K., Y.H. Kim, J.H. Joh, J.M. Kang and U.J. Park et al., 2016 Vascular Specialist Int., 32 77 104 Eriksson, B.I., L.C. Borris, R.J. Friedman, S. Haas and M.V. Huisman et al., 2008 N. Engl. J. Med., 358 2765 2775 Guerin, S., C. Collins, H. Kapoor, I. McClean and D. Collins, 2007 Transfusion Med., 17 37 43 Viera, A.J. and N. Wouk, 2015 Am. Family Phys., 92 487 495 Blanchard, C., F. Pattou, L. Brunaud, A. Hamy and M. Dahan et al., 2017 BJS Open, 1 2 10 Shafiq, N., S. Malhotra, P. Pandhi, N. Sharma, A. Bhalla and A. Grover, 2006 Pharmacology, 78 136 143 Leung, V., E. Zhang and D.S. Pang, 2016 Scient. Rep., Vol. 6. 2016 Gao, Z., F. Cui, X. Cao, D. Wang, X. Li and T. Li, 2017 Biomed. Pharmacother., 92 459 467 Heckmann, M., H. Thermann and F. Heckmann, 2015 Hamostaseologie, 35 358 363 Beyer-Westendorf, J., J. Luetzner, L. Donath, L. Tittl and H. Knoth et al., 2013 Thrombosis Haemostasis, 109 154 163 Nayak, B.K., 2010 Indian J. Ophthalmol., 58 469 470 Brown, D.G., E.C. Wilkerson and W.E. Love, 2015 J. Am. Acad. Dermatol., 72 524 534 Mo, Y. and F.K. Yam, 2015 Pharm.: J. Hum. Pharmacol. Drug Ther., 35 198 207 Gheno, G., L. Cinetto, C. Savarino, S. Vellar, M. Carraro and M. Randon, 2003 Eur. J. Clin. Pharmacol., 59 373 377 PrFRAXIPARINE®, 2015 Product Monograph. Zindel, S., S. Stock, D. Muller and B. Stollenwerk, 2012 BMC Health Serv. Res., Vol. 12. 2012