Rivaroxaban for the treatment of venous thromboembolism

Nils Kucher; Drahomir Aujesky; Jürg H. Beer; Lucia Mazzolai; Thomas Baldi; Martin Banyai; Daniel Hayoz; Thomas Kaeslin; Wolfgang Korte; Robert Escher; Marc Husmann; Beat Frauchiger; Iris Baumgartner; David Spirk

doi:10.1160/TH16-03-0209

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2016; 116(03): 472-479
DOI: 10.1160/TH16-03-0209

Coagulation and Fibrinolysis

Schattauer GmbH

Rivaroxaban for the treatment of venous thromboembolism

The SWIss Venous ThromboEmbolism Registry (SWIVTER)

Nils Kucher

¹Swiss Cardiovascular Center, Bern University Hospital, Bern, Switzerland

,

Drahomir Aujesky

²Division of General Internal Medicine, Bern University Hospital, Bern, Switzerland

,

Jürg H. Beer

³Department of Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland

,

Lucia Mazzolai

⁴Clinic of Angiology, University Hospital Lausanne, Lausanne, Switzerland

,

Thomas Baldi

⁵Department of Internal Medicine, University Hospital Basel, Basel, Switzerland

,

Martin Banyai

⁶Department of Internal Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland

,

Daniel Hayoz

⁷Department of Internal Medicine, Cantonal Hospital Fribourg, Fribourg, Switzerland

,

Thomas Kaeslin

⁸Department of Internal Medicine, Cantonal Hospital Obwalden, Sarnen, Switzerland

,

Wolfgang Korte

⁹Department of Internal Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland

,

Robert Escher

¹⁰Department of Internal Medicine, Regional Hospital Burgdorf, Burgdorf, Switzerland

,

Marc Husmann

¹¹Clinic of Angiology, University Hospital Zurich, Zurich, Switzerland

,

Beat Frauchiger

¹²Department of Internal Medicine, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland

,

Iris Baumgartner

¹Swiss Cardiovascular Center, Bern University Hospital, Bern, Switzerland

,

David Spirk

¹³Institute of Pharmacology, University Bern, Bern, Switzerland

› Institutsangaben

Abstract

Summary

We investigated three-month clinical outcomes in patients with venous thromboembolism (VTE) treated with rivaroxaban or conventional anticoagulation in routine clinical practice. Between November 2012 and February 2015, 2,062 consecutive patients with VTE from 11 acute care hospitals in Switzerland were enrolled in the SWIss Venous ThromboEmbolism Registry (SWIVTER). Overall, 417 (20 %) patients were treated with rivaroxaban. In comparison to 1,645 patients on conventional anticoagulation, patients on rivaroxaban were younger (56 ± 18 vs. 65 ± 17 years; p<0.001), less often had pulmonary embolism (38 % vs 66 %; p<0.001), hypertension (26 % vs 41 %; p<0.001), cancer (10 % vs 28 %; p<0.001), congestive heart failure (10 % vs 17 %; p=0.001), diabetes (8 % vs 15 %; p<0.001), chronic lung disease (7 % vs 13 %; p=0.001), renal insufficiency (7 % vs 13 %; p=0.001), recent surgery (7 % vs 14 %; p<0.001), and acute coronary syndrome (1 % vs 4 %; p=0.009). VTE reperfusion therapy was more frequently used (28 % vs 9 %; p<0.001) and indefinite-duration anticoagulation treatment less often planned (26 % vs 39 %; p<0.001), respectively. In the propensity score-adjusted population, the risk of recurrent VTE was similar in patients on rivaroxaban vs conventional anticoagulation (1.2 % vs 2.1 %, hazard ratio [HR] 0.55, 95 % confidence interval [CI] 0.18–1.65; p=0.29); the risk of major bleeding was also similar, respectively (0.5 % vs 0.5 %, HR 1.00, 95 %CI 0.14–7.07; p=1.00). Conventional anticoagulation is still frequently used for the treatment of VTE, particularly in the elderly and those with comorbidities. Early clinical outcomes were comparable between propensity score-adjusted patient populations on rivaroxaban and conventional anticoagulation.

Keywords

Anticoagulation - rivaroxaban - venous thromboembolism

Volltext

Referenzen

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