Rivaroxaban, the first oral, direct factor Xa inhibitor

Venous thromboembolism (VTE) is a major cause of death in hospitalized patients. In particular, patients undergoing elective major lower-limb orthopaedic surgery are at high risk of developing post-operative VTE. Rivaroxaban, a new oral anticoagulant, has been shown to be more effective than enoxaparin in reducing total and symptomatic VTE with similar major and non-major bleeding rates in patients undergoing elective total hip or total knee replacement.