Rivaroxaban may play an important role in preventing thromboembolic events, as oral administered drug

Summary
The authors report the results of a large randomized trial (n = 4541 patients) comparing rivaroxaban, an inhibitor of factor Xa, with enoxaparin, a low-molecular-weight heparin, in patients undergoing hip arthroplasty. Rivaroxaban was significantly more effective than enoxaparin in preventing venous thromboembolic disease: thromboembolic disease developed in 0.2% of patients treated with rivaroxaban compared with 2.0% of patients treated with enoxaparin (P ≤ .001). There was a nonsignificant increase in major bleeding episodes in the rivaroxaban group (P = .18).

Viewpoint
In this report, rivaroxaban was more effective than low-dose-heparin in the prevention of thromboembolic events after hip surgery. In the same issue, similar findings were reported after knee surgery.[1] One important advantage of rivaroxaban is that it can be administered in a single daily oral dose, in contrast to heparin products, which must be administered subcutaneously. Although the 2 trials were limited to orthopedic patients, it is expected that similar findings would result from a comparison of the 2 agents in general surgical patients. The drug, which is currently undergoing US Food and Drug Administration review, may eventually play an important role in preventing thromboembolic events.