Fondaparinux (Arixtra®) in day-to-day practice

The development of fondaparirux (Arixtra(R)) has led to a major advance in prophylaxis against venous thromboembolism (VTE) following total knee replacement, total hip replacement and hip fracture surgery. Fondaparinux 2.5 mg is administered as a convenient, post-operative, once-daily, subcutaneous injection. Four large, Phase III, clinical trials demonstrated consistently superior efficacy with fondaparinux as compared with current enoxaparin regimeris across various parameters, including type of surgery or anaesthesia, patient subtypes, and surgery characteristics. This superior efficacy was achieved without incurring an increased risk of major bleeding when administered at least 6-hours post-operatively. Furthermore, extending the duration of prophylaxis with fondaparinux, from I to 4 weeks in hip fracture patients, significantly reduced the incidence of total VTE and symptomatic VTE, with event rates of 1.4% and 0.3%, respectively. Based on its efficacy, safety and tolerability profile, and its convenience of use, fondaparinux will establish a new standard of care in the prevention of VTE in patient ubdergoing major, orthopaedic surgery (MOS).