Xarelto Bleeding Risk Higher in Knee Surgery, Acute IllnessNovember 25, 2013 — Medscape reports that Xarelto (rivaroxaban) has been associated with a 4-fold higher risk of major bleeding in patients after knee surgery, and a nearly 3-fold higher risk of bleeding for acutely ill patients.

The conclusions of the study were presented by Dr. Partha Sardar of New York Medical College. The meta-analysis was based on data from 48 randomized clinical trials involving new blood-thinning medications introduced after 2010 — Xarelto, Pradaxa, Eliquis, Lixiana , and darexaban.

The researchers investigated which blood-thinners worked better under different circumstances. They found that the new blood-thinners had significantly higher risks of bleeding in patients undergoing hip surgery, patients with acute coronary syndrome (ACS), and acutely ill patients being treated with a prophylaxis blood-thinner to prevent blood clots.

New blood-thinners had higher risks of bleeding for:

  • Hip surgery: 1.43-fold higher risk of bleeding
  • Acute Coronary Syndrome (ACS): 3.27-fold higher risk of bleeding
  • Medically ill thromboprophylaxis: 2.79-fold higher risk of bleeding

Xarelto was shown to reduce the risk of venous thromboembolism (VTE) and pulmonary embolism (PE).

The research suggests that the new blood-thinners perform differently depending on the clinical setting in which they are prescribed. Therefore, monitoring the benefits and complications of the drugs among diverse patient populations will be very important as they become increasingly popular.

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