Mochizuki Takeshi, Ikari Katsunori, Yano Koichiro, Hiroshima Ryo, Ishibashi Mina, Okazaki Ken
a Department of Orthopedic Surgery , Kamagaya General Hospital , Kamagaya , Japan.
b Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku , Japan.
Mod Rheumatol. 2019 Jul;29(4):682-686. doi: 10.1080/14397595.2018.1504396. Epub 2018 Oct 1.
The aim of this study was to examine the treatment outcomes of edoxaban and apixaban on deep venous thrombosis (DVT) in Japanese patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA). We examined 100 patients receiving edoxaban or apixaban to treat lower limb DVT. The primary efficacy outcome was defined as the disappearance of DVT at three months post-treatment. The primary safety outcome was the change in hemoglobin (Hb) value after two and seven days of treatment compared with baseline, which was the start of treatment with edoxaban or apixaban. The primary efficacy outcome occurred in 61 of the 70 patients (87.1%) in the edoxaban group and in 28 of the 30 patients (93.3%) in the apixaban group. There was no significant difference between the edoxaban and apixaban groups in the disappearance of DVT at three months ( = .497). The change in Hb value from baseline to two days post-treatment was -0.53 ± 0.98 in the edoxaban group and -0.06 ± 0.75 in the apixaban group ( = .010). At seven days post-treatment, the changes in Hb were -0.03 ± 1.60 and 0.30 ± 0.68 ( = .007) in the edoxaban and apixaban groups, respectively. Edoxaban and apixaban were equivalent in efficacy. However, apixaban was superior to edoxaban in terms of the change in Hb value. In cases of major bleeding, both edoxaban and apixaban need to be used carefully when treating DVT.
本研究旨在探讨依度沙班和阿哌沙班对接受全膝关节置换术（TKA）或全髋关节置换术（THA）的日本患者深静脉血栓形成（DVT）的治疗效果。我们研究了100例接受依度沙班或阿哌沙班治疗下肢DVT的患者。主要疗效指标定义为治疗后三个月DVT消失。主要安全性指标是治疗两天和七天后血红蛋白（Hb）值相对于基线（即依度沙班或阿哌沙班治疗开始时）的变化。依度沙班组70例患者中有61例（87.1%）出现主要疗效指标，阿哌沙班组30例患者中有28例（93.3%）出现该指标。依度沙班组和阿哌沙班组在三个月时DVT消失情况无显著差异（P = 0.497）。依度沙班组治疗后两天Hb值相对于基线的变化为-0.53±0.98，阿哌沙班组为-0.06±0.75（P = 0.010）。治疗七天后，依度沙班组和阿哌沙班组Hb的变化分别为-0.03±1.60和0.30±0.68（P = 0.007）。依度沙班和阿哌沙班疗效相当。然而，在Hb值变化方面，阿哌沙班优于依度沙班。在发生大出血的情况下，治疗DVT时依度沙班和阿哌沙班均需谨慎使用。
