• activity76920
  • CME

  • Novel Oral Anticoagulants for VTE Prevention in Orthopedic Surgery: Overview of Phase 3 Trials

  • Author(s)/Faculty: Richard J. Friedman, MD, FRCSC
    Source: Orthopedics 34:10
    Type: Journal Articles/Items: 1
    Release Date: 10/1/2011 Expiration Date: 10/31/2012
    Credit Type: CME Number of Credit(s): 1
    Cost: $15 Provider:

  • Outpatient use of anticoagulants to prevent venous thromboembolism after total hip or knee arthroplasty may be hampered either by requirements for parenteral administration or high variability and frequent monitoring of anticoagulant activity. Trials of the new oral direct factor Xa inhibitors rivaroxaban and apixaban and the direct thrombin inhibitor dabigatran indicate that they can be administered in fixed doses without monitoring and that they generally have efficacy at least equivalent to enoxaparin, although with potential minor differences in the balance of efficacy vs risk for bleeding. This article reviews the results and pharmacokinetic properties that may influence their use in clinical practice.

Educational Objectives

As a result of reading this article, physicians should be able to:

  1. Recognize the limitations of currently recommended approaches to thromboprophylaxis in patients undergoing total hip and knee arthroplasty.
  2. Compare the efficacy vs risk of various therapeutic options in specific patient populations.
  3. Critically review available data for existing therapies and new anticoagulant agents in the prevention of venous thromboembolism in orthopedic surgery.
  4. Identify the pharmacokinetic properties that may influence clinical practice.

This activity is approved for one year from the date of original release, October 1, 2011 to October 31, 2012.

CME Accreditation

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Vindico Medical Education and Orthopedics. Vindico Medical Education is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

Vindico Medical Education designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This CME activity is primarily targeted to orthopedic surgeons, hand surgeons, head and neck surgeons, trauma surgeons, physical medicine specialists, and rheumatologists. There is no specific background requirement for participants taking this activity.

How to Participate in this Activity and Obtain CME Credit

To participate in this CME activity, you must read the objectives and articles, review the presentations, complete the CME test, and complete and submit the registration form and evaluation. Give only one (1) correct answer for each question. A satisfactory score is defined as answering 80% of the questions correctly. Upon receipt of the completed materials, if a satisfactory score on the CME test is achieved, Vindico Medical Education will issue an AMA PRA Category 1™ Certificate within 4 to 6 weeks.

This CME activity is primarily targeted to orthopedic surgeons, hand surgeons, head and neck surgeons, trauma surgeons, physical medicine specialists, and rheumatologists. There is no specific background requirement for participants taking this activity.

Full Disclosure Policy

In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of the planners, teachers, and authors involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control.

Dr Friedman is a consultant for Cadence, DJO Surgical, and Pfizer. Editorial and writing support for this manuscript was provided by Robert Rhoades, PhD, and Keith Day, PhD, of PAREXEL and was funded by Bristol-Myers Squibb and Pfizer. Dr D’Ambrosia, Editor-in-Chief, has no relevant financial relationships to disclose. The staff of ORTHOPEDICS have no relevant financial relationships to disclose.

The material presented in any Vindico Medical Education continuing education activity does not necessarily reflect the views and opinions of ORTHOPEDICS or Vindico Medical Education. Neither ORTHOPEDICS nor Vindico Medical Education nor the authors endorse or recommend any techniques, commercial products, or manufacturers. The authors may discuss the use of materials and/or products that have not yet been approved by the US Food and Drug Administration. All readers and continuing education participants should verify all information before treating patients or using any product.

Unlabeled and Investigational Usage

The audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products or to products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage.