Aspirin alone is non-inferior to rivaroxaban followed by aspirin for VTE prophylaxis after total hip or knee arthroplasty, according to a study.

The EPCAT III randomised controlled trial is an extension of the EPCAT II trial, which demonstrated that extended prophylaxis with low-dose aspirin was non-inferior to continued rivaroxaban for preventing VTE after hip or knee arthroplasty.

The results of EPCAT III, published in The New England Journal of Medicine, showed aspirin as non-inferior to rivaroxaban for five days followed by aspirin for the prevention of VTE during the 90-day postoperative period.

The Canadian study randomised 5429 patients with a mean age of 66.5 to receive once-daily thromboprophylaxis of either 81mg of aspirin or 10mg of rivaroxaban for five days postoperatively, followed by 81mg of aspirin daily for nine additional days in patients undergoing knee arthroplasty and 30 days in those undergoing hip arthroplasty.