Comparing the Efficacy, Safety and Cost of the Anticoagulants: Rivaroxaban and Nadroparin in Hip Replacement Surgery

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 kgG 1 b.wt.) and group III patients received high-dose nadroparin calcium (6,500 anti-Xa IU kgG 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 Dunnettʼs 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 patientʼs condition.