Modern oral medications to prevent venous thromboembolism – critical review of evidence base in terms of a risk/benefit ratio

Sereda A.P.

Abstract


Modern oral medications used to prevent venous thromboembolism (VTE) have gained widespread use with major orthopaedic and trauma procedures. There are no accurate multicenter data on the frequency of usage of different prophylactic medications in our country but discussions of the colleagues at specialized web forums make us suspect that factor Xa and dabigatran etexilate inhibitors are in the top three next to low molecular weight heparins. Marketing and promotion strategies of pharmaceutical companies are likely to be of immense importance in that with the contribution of clinical research studies for pharmaceutical drugs. However, preferences of European and American orthopaedic surgeons for the choice of drugs are completely different from those of Russian surgeons. Vitamin K antagonists, acetylsalicylic acid, low molecular weight heparins are commonly used for antithrombotic therapy abroad. Different approaches of Russian and foreign orthopaedic surgeons to the choice of drugs can be explained by a different use of a high-quality evidence base. In our opinion, a collision component can be involved in the endpoints of clinical trials that will be discussed in the present critical review.

Keywords


venous thromboembolism, prophylaxis, arthroplasty, evidence-based medicine, pulmonary embolism

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DOI: http://dx.doi.org/10.18019/1028-4427-2019-25-3-424-428

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