6/28/23, 9:58 PM EPCAT II Pathway Feedback Search Clinical Topics Home Studies EPCAT II EPCAT II Disease Disease Disease Hip fracture Knee osteoarthritis Periope Trial question Is aspirin noninferior to rivaroxaban for the prevention of VTE in patients undergoing total hip arthroplasty or total knee arthroplasty? Study design Multi-center Double blinded RCT Population Characteristics of study participants 52.0% female N = 3424 48.0% male 3424 patients (1787 female, 1637 male) Inclusion criteria: patients who underwent total hip arthroplasty or total knee arthroplasty and received once-daily oral rivaroxaban 10 mg until postoperative day 5 Key exclusion criteria: hip or lower limb fracture during the previous 3 months and metastatic cancer Interventions N=1707 aspirin (81 mg daily for additional 9 days after total knee arthroplasty or for 30 days after total hip arthroplasty) N=1717 rivaroxaban (continued 10 mg for an additional 9 days after total knee arthroplasty or for 30 days after total hip arthroplasty) Primary outcome Venous thromboembolism https://web.pathway.md/studies/rec9Hz4k4zZFRIWq5 1/2 6/28/23, 9:58 PM EPCAT II Pathway 0.7 % 0.7 0.64 0.5 % 0.3 % Difference not exceeding nonferiority margin 0.2 % 0.0 % Aspirin Rivaroxaban Difference not exceeding nonferiority margin in VTE (0.64% vs. 0.7%; AD 0.06%, 95% CI -0.55 to 0.66) Secondary outcomes No significant difference in major bleeding (0.47% vs. 0.29%; AD 0.18%, 95% CI -0.65 to 0.29) No significant difference in major bleeding and clinically relevant nonmajor bleeding (1.29% vs. 0.99%; AD 0.3%, 95% CI -1.07 to 0.47) Safety outcomes No significant differences in major bleeding complications, deep vein thrombosis in the calf. Conclusion In patients who underwent total hip arthroplasty or total knee arthroplasty and received once- daily oral rivaroxaban 10 mg until postoperative day 5, aspirin was noninferior to rivaroxaban with respect to VTE. Reference Anderson DR, Dunbar M, Murnaghan J et al. Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty. N Engl J Med. 2018 Feb 22;378(8):699-707. Open reference URL https://web.pathway.md/studies/rec9Hz4k4zZFRIWq5 2/2