Perioperative medicine & outcomes
Rivaroxaban Then Aspirin vs. Aspirin Alone after Total Hip or Knee Arthroplasty
An erratum to this article was published (N Engl J Med, 13 Aug 2026 ↗)
Primary resultResult — go to the resultRisk difference 0.02 percentage points 95% CI −0.34 to 0.39Authors' conclusion
After total hip and total knee arthroplasty, the use of aspirin alone was not inferior to a strategy of using rivaroxaban followed by aspirin for the prevention of symptomatic venous thromboembolism, with no clinically relevant difference in bleeding events.
Study context
- Population
- Patients after total hip or total knee arthroplastyrandomised
- Participants
- 5,429 patients
- Comparison
- Aspirin alone vs rivaroxaban then aspirin for thromboprophylaxis
- Aspirin alonen = 2,718
- Rivaroxaban-aspirinn = 2,647reference
- Primary endpoint
- Symptomatic venous thromboembolism (proximal deep-vein thrombosis or pulmonary embolism) (primary effectiveness outcome)
- Follow-up
- 90 days
Methodological detailsmulticentre, double-blind, non-inferiority
- Multicentre
- Double-blind
- Non-inferiority
Primary result
As reported in the abstract
Risk difference
0.02 percentage points
95% CI −0.34 to 0.39
P < 0.001 for non-inferiority
Events by treatment group
Aspirin alone vs Rivaroxaban-aspirin
risk difference 0.02 percentage points (95% CI −0.34 to 0.39); P for non-inferiority < 0.001
Safety
| Outcome | Aspirin alone | Rivaroxaban-aspirin | Risk difference (95% CI) | |
|---|---|---|---|---|
| Major or clinically relevant nonmajor bleeding (primary safety outcome) | 1.66% | 2.04% | −0.38% (−1.11 to 0.34) | |
| −1.5−1−0.500.5Difference (linear scale) |
Original publication
Rivaroxaban Then Aspirin vs. Aspirin Alone after Total Hip or Knee Arthroplasty. N Engl J Med. Published 12 July 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →