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July 11, 2011

FDA approves Xarelto - a tablet to prevent DVT

Blood clots in the legs and lungs are a common and potentially deadly problem, especially after trauma, and hip or knee replacement surgery. Typically, we've used heparin, or more recently lovenox, injections to reduce the chance of these problems. But now, there's a tablet that does the same thing: Xarelto. You'll want to remember this name.

It was approved just this week, by the FDA, as a preventative measure against deep vein thrombosis (DVT), and pulmonary embolism (PE) following knee or hip replacement surgery. It's been approved in Europe and Canada for several years.

Xarelto is a pill taken once daily - how easy is that?! No blood tests are required. Patients having a knee replacement should take the medication for 12 days and patients undergoing a hip replacement procedure should take Xarelto for 35 days after surgery.

According to the studies, Xarelto was more effective than injections of Lovenox - our current standard treatment - in preventing DVT. In a study of more than 6,000 orthopedic patients, 9.7 percent of knee-replacement patients treated with Xarelto had a clot problem, compared with 18.8 percent of knee-replacement patients who received Lovenox. In a study involving hip replacement surgery, 1.1 percent of patients who received Xarelto had clots compared with 3.9 percent of those who received Lovenox.

So far, no one has done a study in plastic surgery patients, especially abdominoplasty. Under the current FDA labelling, that would be considered an "off-label" use. But if you had a family history of DVT, or you personally have had a DVT or PE in the past - this might be a new method to reduce your risk of having a blood clot after surgery. Interesting stuff!!

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