Analysis of the efficacy and safety of Dabigatran 220 mg vs.150 mg for prevention of thromboembolism after hip or knee replacement

Objective We sought to conduct a systematic review of efficacy and safety of Dabigatran 220 mg vs.150 mg for prevention of thromboembolism after hip or knee replacement.Methods We searched the Cochrane Library,EMBASE,Medline Databases,PubMed,CNKI,VIP,and Wanfang Data,from the date of 1990 to 2012.The bibliographies of the included studies were searched,too.Two independent researchers evaluated the included studies using GRADE.The meta-analysis was performed by Review Manager 5.1 software.Results A total of 4 trials were identified,which included 8722 patients.The efficacy of Dabigatran 220 mg prefers to Dabigatran 150 mg for prevention of thromboembolism after hip or knee replacement,total VTE and all-cause mortality(OR=0.82,95% CI=0.70,0.95),total DVT(OR=0.84,95% CI=0.72,0.98),proximal DVT(OR=0.58,95% CI=0.40,0.84),distal DVT(OR=0.83,95% CI=0.70,0.98).But some were of no statistical significance,Symptomatic VTE or death(OR=0.87,95% CI=0.49,1.53),major VTE and VTE-related mortality(OR=0.80,95% CI=0.57,1.12).The bleeding risk of 220 mg vs.150 mg had no significant difference,major bleeding(OR=1.38,95% CI=0.87,2.20),clinically relevant bleeding(OR=1.04,95% CI=0.80,1.35),minor bleeding(OR=0.99,95% CI=0.78,0.94).Conclusions The efficacy of Dabigatran 220 mg prefers to Dabigatran 150 mg for prevention of thromboembolism after hip or knee replacement,and the bleeding risk of 220 mg vs.150 mg has no significant difference.