Comparative safety and effectiveness of rivaroxaban versus VKAs in patients with venous thromboembolism

Caroline Sindet-Pedersen; Jannik Langtved Pallisgaard; Laila Staerk; Thomas Alexander Gerds; Emil Loldrup Fosbøl; Christian Torp-Pedersen; Gunnar Gislason; Jonas Bjerring Olesen

doi:10.1160/TH16-10-0745

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2017; 117(06): 1182-1191
DOI: 10.1160/TH16-10-0745

Stroke, Systemic or Venous Thromboembolism

Schattauer GmbH

Comparative safety and effectiveness of rivaroxaban versus VKAs in patients with venous thromboembolism

A Danish nationwide registry-based study

Caroline Sindet-Pedersen

¹Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark

³Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

,

Jannik Langtved Pallisgaard

¹Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark

³Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

,

Laila Staerk

¹Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark

³Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

,

Thomas Alexander Gerds

²The Danish Heart Foundation, Copenhagen, Denmark

⁷Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark

,

Emil Loldrup Fosbøl

¹Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark

²The Danish Heart Foundation, Copenhagen, Denmark

⁶Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark;

,

Christian Torp-Pedersen

¹Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark

⁵Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark

,

Gunnar Gislason

¹Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark

²The Danish Heart Foundation, Copenhagen, Denmark

³Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

⁴The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark

,

Jonas Bjerring Olesen

¹Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark

› Institutsangaben

Abstract

Summary

The approval of rivaroxaban has changed the landscape of treatment of venous thromboembolism (VTE). Little is known about the effect of rivaroxaban compared with vitamin K antagonists (VKA), when used in the everyday clinical practice. The aim of this study was to investigate the safety and effectiveness of rivaroxaban compared with VKAs among patients with VTE, using the Danish nationwide registries. All patients diagnosed with VTE and treated with either rivaroxaban or VKAs between 2013 and 2015 were included. A total of 12,318 patients were diagnosed with VTE and treated with VKAs [n=6,907] or rivaroxaban [n=5,411.]. Combined Cox regression analyses showed that the standardised absolute six-month risk of recurrent VTE was 3.03 % [95 % CI: 2.57 % to 3.48 %] in the rivaroxaban group and 3.13 % [95 % CI: 2.70 % to 3.56 %] in the VKA group (absolute risk difference of –0.11 % [95 % CI: –0.76 % to 0.54 %]). The standardised absolute six-months risk of bleeding was 2.28 % [95 % CI: 1.87 % to 2.67 %] for patients in the rivaroxaban group and 2.10 % [95 % CI: 1.78 % to 2.43 %] in the VKA group (absolute risk difference of 0.18 % [95 % CI: –0.34 % to 0.67]). In conclusion, rivaroxaban was associated with similar risk of recurrent VTE and bleeding compared with VKA.

Supplementary Material to this article is available online at www.thrombosis-online.com.

Keywords

Venous thromboembolism - anticoagulation - vitamin K antagonists - rivaroxaban - non-vitamin K antagonist oral anticoagulants

Volltext

Referenzen

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