Evaluation and comparison of adverse drug reactions of rivaroxaban and apixaban in patients undergoing hip and knee joint replacement surgery in Shohada hospital of Tabriz

Abstract

Introduction: Rivaroxaban, apixaban and edoxaban inhibit factor Xa in the final common pathway of coagulation and prescribed as a fixed dose and do not require monitoring. Aim: Evaluation and comparison of adverse drug reactions of rivaroxaban and apixaban in patients undergoing hip and knee joint replacement surgery in Shohada hospital of Tabriz.Materials and Methods: This study was a retrospective cross-sectional study on patients undergoing knee or hip joint replacement surgery who were admitted to Shahada Hospital and referred to this center for treatment monitoring. In this study, patients undergoing knee or hip joint replacement surgery who receive apixaban or rivaroxaban for prophylaxis were examined. The length of the study period is 6 months.Results: In this cross-sectional study, the number of 160 hip or knee arthroplasty candidates who received prophylaxis with rivaroxaban or apixaban were investigated. 40% of the patients were male and the average age of the patients was 54.79±11.29. In general, 85 ADR cases were observed, of which 64.7% were related to rivaroxaban and 35.3% were related to apixaban. It was observed that the frequency of ADR was significantly higher in patients receiving rivaroxaban; So that the frequency of bleeding after surgery gastrointestinal bleeding and melena in the rivaroxaban receiving group was significantly higher than the apixaban receiving group. Conclusion: Compared to rivaroxaban, the use of apixaban in patients who are candidates for hip or knee arthroplasty for antithrombotic prophylaxis is associated with less major and minor bleeding. The main side effect of both drugs (bleeding) is related to the nature of the drug and can be controlled. Both drugs had acceptable efficacy in VTE and DVT prophylaxis, and the rate of re-hospitalization and the frequency of ADR improvement were not statistically significantly different between the two groups.