Fondaparinux vs Enoxaparin for the Prevention of Venous Thromboembolism in Major Orthopedic SurgeryA Meta-analysis of 4 Randomized Double-blind Studies

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Abstract
DESPITE THE USE of currently available thromboprophylactic treatments, venous thromboembolism (VTE) is still frequent, and it remains a life-threatening complication in patients undergoing major orthopedic surgery.1,2 Thus, there is still a need for improved thromboprophylactic treatment in these patients. The pentasaccharide fondaparinux is the first of a new class of synthetic antithrombotic agents that acts through specific inhibition of factor Xa, devoid of direct activity against thrombin (factor IIa).3-5 This inactivation of factor Xa via antithrombin results in effective inhibition of thrombin generation.6,7 Fondaparinux sodium is 100% bioavailable when administered subcutaneously and does not undergo metabolism. In healthy volunteers, fondaparinux exhibits a linear pharmacokinetic profile with little variability between subjects.8 The half maximum plasma concentration is reached within 25 minutes, and the dose-independent elimination half-life is 15 hours, allowing once-daily administration.

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