Rivaroxaban treatment for asymptomatic venous thromboembolism: insights from the J’xactly study

Thrombosis Journal

Research

Ikuo Fukuda¹  Norikazu Yamada²  Atsushi Hirayama³  Morimasa Takayama⁴  Takeshi Yamashita⁵  Takanori Ikeda⁶  Makoto Mo⁷  Hideaki Maeda⁸  Yasuo Okumura⁹  Shohei Migita⁹  Tsutomu Yamazaki^1,10  Mashio Nakamura^1,11 

[1] Department of Cardiology, Keimeikai Yokawa Hospital, Miki, Japan;Department of Cardiology, Kuwana City Medical Center, Kuwana, Japan;Department of Cardiology, Osaka Police Hospital, Osaka, Japan;Department of Cardiology, Sakakibara Heart Institute, Fuchu, Japan;Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan;Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan;Department of Cardiovascular Surgery, Yokohama Minami Kyosai Hospital, Yokohama, Japan;Department of Heart and Vascular Center, Ukima Central Hospital, Tokyo, Japan;Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Ohyaguchi-kamicho, Itabashi-ku, 173-8610, Tokyo, Japan;Innovation and Research Support Center, International University of Health and Welfare, Tokyo, Japan;Nakamura Medical Clinic, Kuwana, Japan;

关键词: Anticoagulant;    Bleeding;    Recurrence;    Rivaroxaban;    Venous thromboembolism;   

DOI  :  10.1186/s12959-023-00528-w

 received in 2023-03-19, accepted in 2023-08-02,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAn established treatment strategy for asymptomatic pulmonary embolism (PE) or deep vein thrombosis (DVT) remains uncertain in Japan; therefore, in this study, we clarify the characteristics and outcomes of symptomatic compared to asymptomatic patients with PE or DVT.MethodsThis prospective, multicenter sub-analysis of the J’xactly study in Japan included 1,016 patients (mean age, 68; 41% male) with venous thromboembolism (VTE) treated with rivaroxaban.ResultsAsymptomatic PE patients (47% of PE patients) were more likely to have active cancer and asymptomatic proximal DVT at lower severity than symptomatic PE patients, despite no differences in age, sex, or the proportion receiving intensive 30 mg/day-rivaroxaban. Patients with asymptomatic DVT (34% of DVT patients) were older, had higher rates of female sex, active cancer, and distal DVT, and received shorter, less intense rivaroxaban treatment. Incidences did not differ between asymptomatic and symptomatic PE patients for recurrent symptomatic VTE (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.22–1.62; P = 0.31) or major bleeding (HR, 0.68; 95% CI, 0.20–2.33; P = 0.58), nor between asymptomatic and symptomatic DVT patients for recurrent symptomatic VTE (HR, 0.56; 95% CI, 0.23–1.40; P = 0.21) and major bleeding (HR, 1.47; 95% CI, 0.54–3.97; P = 0.45).ConclusionsThe real-world composite adverse event rate for treatment with rivaroxaban, as physician-adjusted for dose and duration, was similar for asymptomatic and symptomatic patients regardless of the presence of PE or DVT, suggesting a favorable safety profile for potential rivaroxaban treatment for asymptomatic VTE.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

13570_2023_282_Article_IEq1.gif

Fig. 2

Fig. 4