Study of an Investigational Drug for the Prevention of Thrombosis-related Events Following Knee Replacement Surgery (ADVANCE-2)
Deep Vein Thrombosis, Pulmonary Embolism
About this trial
This is an interventional treatment trial for Deep Vein Thrombosis focused on measuring Prevention of deep vein thrombosis and pulmonary embolism after total knee replacement surgery
Eligibility Criteria
Key Inclusion Criteria
- Patients scheduled for either elective unilateral or same-day bilateral total knee replacement surgery (TKR) or a revision of at least 1 component of a TKR
- Patients willing and able to undergo bilateral ascending contrast venography
Key Exclusion Criteria
- Known or suspected hereditary or acquired bleeding or coagulation disorders in the participant or his or her first-degree relative
- Known or suspected history of heparin-induced thrombocytopenia
- Known coagulopathy
- Active bleeding or at high risk for bleeding
- Brain, spinal, ophthalmologic, or major surgery or trauma within the past 90 days
- Active hepatobiliary disease
- Alcohol and/or substance abuse within the past year
- Any condition for which, in the opinion of the investigator, surgery or administration of an anticoagulant was contraindicated
- Two consecutive blood pressure readings within 15 to 30 minutes with supine systolic blood pressure >180 mm Hg or supine diastolic blood pressure >105 mm Hg
Clinically significant laboratory abnormalities at the enrollment visit:
- Hemoglobin <10 g/dL
- Platelet count <100,000/mm^3
- Creatinine clearance <30 mL/min, as estimated by the method of Cockcroft and Gault
- Alanine aminotransferase or aspartate aminotransferase level >2*upper limit of normal (ULN) or a total bilirubin ≥1.5*ULN (unless an alternative causative factor such as Gilbert's syndrome was identified)
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Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Apixaban, 2.5 mg BID + Placebo
Enoxaparin, 40 mg QD + Placebo
Participants received apixaban, 2.5-mg tablets twice daily (BID), plus a matching enoxaparin-placebo injection 12 (±3) hours prior to hip-replacement surgery through 11 (±2) days after the day of surgery.
Participants received enoxaparin, 40-mg subcutaneous injection once daily (QD), plus a matching apixaban-placebo tablet 12 (±3) hours prior to hip-replacement surgery through 11 (±2) days after the day of surgery.