Rivaroxaban Then Aspirin vs. Aspirin Alone after Total Hip or Knee Arthroplasty.

Aspirin alone after total hip or knee arthroplasty is noninferior to rivaroxaban followed by aspirin for symptomatic venous thromboembolism, with rates of 0.48% vs 0.45%.

• Why it matters: Uncertainty remained about whether aspirin alone could match the safety and effectiveness of an initial short course of rivaroxaban after arthroplasty.
• What they did: In a multicenter, double-blind randomized trial of 5429 patients, participants received 81 mg aspirin or 10 mg rivaroxaban daily for 5 days, then 81 mg aspirin daily for 9 days after knee or 30 days after hip, followed for 90 days.
• The result: Symptomatic venous thromboembolism occurred in 13/2718 vs 12/2647 (risk difference 0.02 percentage points; 95% CI -0.34 to 0.39; P<0.001 for noninferiority), and major or clinically relevant nonmajor bleeding was 1.66% vs 2.04% without a clinically relevant difference.

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