Subscribe to RSS
DOI: 10.12687/phleb2320-4-2016
Safety and effectiveness of rivaroxaban versus standard anticoagulation for the treatment of symptomatic deep vein thrombosis in routine clinical practice
Subgroup analysis of XALIA-DE for Germany Article in several languages: English | deutschPublication History
Received:
27 June 2016
Accepted:
28 June 2016
Publication Date:
21 December 2017 (online)
Summary
In addition to parenteral anticoagulants and vitamin K antagonists (standard AC), non-vitamin K antagonist oral anticoagulants (NOAC) are increasingly being used for the acute and long-term treatment of deep vein thrombosis (DVT).
The international, prospective, non-interventional XALIA study compared the acute and long-term treatment of DVT with rivaroxaban or standard AC under routine clinical practice and confirmed the safety and efficacy of rivaroxaban demonstrated in Phase III studies: annual event rates for major bleeding, VTE and all-cause mortality were 1.2 %, 2.4 % and 0.8 % respectively, compared to 3.4 %, 3.9 %, and 6.2 % with standard AC.
The XALIA-DE subgroup analysis examined whether the XALIA results were applicable to Germany. The 586 rivaroxaban patients were younger and fewer had active cancer than the 355 treated with standard AC. As in XALIA, the incidence of major bleeding (1.6 vs. 4.1/100 patient-years [PY]), recurrent VTE (1.9 vs. 4.7/100 PY) and all-cause mortality (1.6 vs. 6.8/100 PY) were lower under rivaroxaban than under standard AC. These rates indicate a favourable benefit-risk profile of rivaroxaban under the conditions of everyday practice.
-
References
- 1 Goldhaber SZ. Venous thromboembolism: epiodemiology and magnitude of the problem. Best Pract Res Clin Haematol 2012; 25: 235-242.
- 2 Heit JA. Epidemiology of venous thromboembolism. Nat Rev Cardiol 2015; 12: 464-474.
- 3 Barnes GD, Kanthi Y, Fröhlich JB. Venous thromboembolism: Predicting recurrence and the need for extended anticoagulation. Vasc Med 2015; 20: 143-152.
- 4 Haas S, Encke A, Kopp I. S3-Leitlinie zur Prophylaxe der venösen Thromboembolie. Neues und Bewährtes. Dtsch Med Wochenschr. 2016 DOI: 10.1055/s-0042–100484.
- 5 Hach-Wunderle V, Gerlach H, Konstantinides S. et al. Interdisziplinäre S2k Leitlinie: Diagnostik und Therapie der Venenthrombose und der Lungenembolie; Registernummer 065 – 002. VASA. 2016 45. (suppl.90): in press.
- 6 Kearon C, Akl EA, Ornelas J. et al. Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report. Chest 2016; 149 (02) 315-352.
- 7 Burness CB, Perry CM. Rivaroxaban: a review of its use in the treatment of deep vein thrombosis or pulmonary embolism and the prevention of recurrent venous thromboembolism. Drugs 2014; 74: 243-262.
- 8 Schinzel H. Heparine – DOAKs – VKA: Pro und Contra unter besonderer Berücksichtigung von Tumorpatienten. Phlebologie 2015; 44: 307-315.
- 9 EINSTEIN Investigators. Bauersachs R, Berkowitz SD, Brenner B. et al. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med 2010; 363: 2499-2510.
- 10 EINSTEIN-PE Investigators, Büller HR, Prins MH, Lensin AW. et al. Oral rivaroxaban for the treatment of symptomatic pulmonary embolism. N Engl J Med 2012; 366: 1287-1297.
- 11 Ageno W, Mantovani LG, Haas S. et al. Safety and effectiveness of oral rivaroxaban versus standard anticoagulation for the treatment of symptomatic deep-vein thrombosis (XALIA): an international, prospective, non-interventional study. Lancet Haemtol 2016; 03: e12-21.
- 12 Ageno W, Mantovani LG, Haas S. et al. XALIA: rationale and design of a non-interventional study of rivaroxaban compared with standard therapy for initial and long-term anticoagulation in deep vein thrombosis. Thromb J 2014; 12: 16 DOI: 10.1186/1477–9560–12–16.
- 13 Bauersachs RM. Managing venous thromboembolism with novel oral anticoagulants in the elderly and other high-risk patient groups. Eur J Intern Med 2014; 25: 600-606.
- 14 Prins MH, Lensing AW, Bauersachs R. et al. Oral rivaroxaban versus standard therapy for the treatment of symptomatic venous thromboembolism: a pooled analysis of the EINSTEIN-DVT and PE randomized studies. Thromb J 2013; 11: 21 DOI:10.1186/1477–9560–11–21.
- 15 Hecker J, Marten S, Keller L. et al. Effectiveness and safety of rivaroxaban therapy in daily-care patients with atrial fibrillation. Results from the Dresden.