SECONDARY PROPHYLAXIS OF VENOUS THROMBOEMBOLISM (VTE) WITH LOW DOSE APIXABAN OR RIVAROXABAN: RESULTS FROM A PATIENT POPULATION WITH MORE THAN 2 YEARS OF MEDIAN FOLLOW-UP
Background: Direct oral anticoagulants (DOACs) are widely used for the treatment and secondary prophylaxis of venous thromboembolism (VTE). Nowadays, DOACs represent the gold standard for long-term anticoagulation, with low-intensity DOACs administration becoming increasingly used worldwide in such...
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PAGEPress Publications
2024-02-01
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| Series: | Mediterranean Journal of Hematology and Infectious Diseases |
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| Online Access: | https://www.mjhid.org/mjhid/article/view/5567 |
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| author | Alessandro Laganà Giovanni Manfredi Assanto Chiara Masucci Mauro Passucci Livia Donzelli Alessandra Serrao Erminia Baldacci Cristina Santoro Antonio Chistolini |
| author_facet | Alessandro Laganà Giovanni Manfredi Assanto Chiara Masucci Mauro Passucci Livia Donzelli Alessandra Serrao Erminia Baldacci Cristina Santoro Antonio Chistolini |
| author_sort | Alessandro Laganà |
| collection | DOAJ |
| description |
Background: Direct oral anticoagulants (DOACs) are widely used for the treatment and secondary prophylaxis of venous thromboembolism (VTE). Nowadays, DOACs represent the gold standard for long-term anticoagulation, with low-intensity DOACs administration becoming increasingly used worldwide in such scenario. Albeit low-intensity apixaban and rivaroxaban are approved for clinical usage as secondary VTE prophylaxis, there are few literature data regarding their efficacy and safety with a long follow-up.
Objectives: The aim of our study was to evaluate the efficacy and safety of low-dose DOACs for VTE secondary prophylaxis, in patients at high risk of VTE recurrence.
Methods: We retrospectively evaluated patients who required long-term anticoagulant secondary prophylaxis to prevent recurrent VTE, treated with apixaban 2.5 mg BID or rivaroxaban 10 mg daily with a follow-up ≥ 12 months.
Results: The examined patients were 323. The median low-dose DOACs administration time was 25.40 months (IQR 13.93-45.90). Twelve (3.7%) VTE recurrences were observed; 21 bleeding events were registered (6.5%), including one episode of MB (0.3%), 8 CRNMB (2.5%) and 12 minor bleeding (3.7%). No statistically significant difference in the rate of VTE recurrence and/or bleeding events emerged between rivaroxaban and apixaban groups. Patients included in the study for multiple episodes of VTE presented a significant higher risk of a new VTE recurrence during low-intensity DOAC.
Conclusions: Our data suggest that low-dose DOACs may be effective and safe in the secondary VTE prophylaxis in patients at high risk of VTE recurrence, but attention might be needed in their choice in such scenario for patients who experienced multiple episodes of VTE.
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| format | Article |
| id | doaj-art-95e7dfac04304339beeec759435a92eb |
| institution | Kabale University |
| issn | 2035-3006 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Mediterranean Journal of Hematology and Infectious Diseases |
| spelling | doaj-art-95e7dfac04304339beeec759435a92eb2025-02-03T00:08:30ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062024-02-0116110.4084/MJHID.2024.020SECONDARY PROPHYLAXIS OF VENOUS THROMBOEMBOLISM (VTE) WITH LOW DOSE APIXABAN OR RIVAROXABAN: RESULTS FROM A PATIENT POPULATION WITH MORE THAN 2 YEARS OF MEDIAN FOLLOW-UPAlessandro Laganà0Giovanni Manfredi Assanto1Chiara Masucci2Mauro Passucci3Livia Donzelli4Alessandra Serrao5Erminia Baldacci6Cristina Santoro7Antonio Chistolini8a:1:{s:5:"en_US";s:28:"Sapienza Università di Roma";}Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, ItalyHematology, Department of Translational and Precision Medicine, Sapienza University of Rome, ItalyHematology, Department of Translational and Precision Medicine, Sapienza University of Rome, ItalyHematology, Department of Translational and Precision Medicine, Sapienza University of Rome, ItalyHaematology and Stem Cell Transplant Unit, A. O. San Camillo Forlanini (L.R.), Rome, ItalyHematology, Department of Translational and Precision Medicine, Sapienza University of Rome, ItalyHematology, Department of Translational and Precision Medicine, Sapienza University of Rome, ItalyHematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy Background: Direct oral anticoagulants (DOACs) are widely used for the treatment and secondary prophylaxis of venous thromboembolism (VTE). Nowadays, DOACs represent the gold standard for long-term anticoagulation, with low-intensity DOACs administration becoming increasingly used worldwide in such scenario. Albeit low-intensity apixaban and rivaroxaban are approved for clinical usage as secondary VTE prophylaxis, there are few literature data regarding their efficacy and safety with a long follow-up. Objectives: The aim of our study was to evaluate the efficacy and safety of low-dose DOACs for VTE secondary prophylaxis, in patients at high risk of VTE recurrence. Methods: We retrospectively evaluated patients who required long-term anticoagulant secondary prophylaxis to prevent recurrent VTE, treated with apixaban 2.5 mg BID or rivaroxaban 10 mg daily with a follow-up ≥ 12 months. Results: The examined patients were 323. The median low-dose DOACs administration time was 25.40 months (IQR 13.93-45.90). Twelve (3.7%) VTE recurrences were observed; 21 bleeding events were registered (6.5%), including one episode of MB (0.3%), 8 CRNMB (2.5%) and 12 minor bleeding (3.7%). No statistically significant difference in the rate of VTE recurrence and/or bleeding events emerged between rivaroxaban and apixaban groups. Patients included in the study for multiple episodes of VTE presented a significant higher risk of a new VTE recurrence during low-intensity DOAC. Conclusions: Our data suggest that low-dose DOACs may be effective and safe in the secondary VTE prophylaxis in patients at high risk of VTE recurrence, but attention might be needed in their choice in such scenario for patients who experienced multiple episodes of VTE. https://www.mjhid.org/mjhid/article/view/5567dose-reducedDeep vein thrombosisDirect oral anticoagulants (DOACs)Venous thromboembolism secondary prophylaxisVTE recurrenceBleeding adverse events |
| spellingShingle | Alessandro Laganà Giovanni Manfredi Assanto Chiara Masucci Mauro Passucci Livia Donzelli Alessandra Serrao Erminia Baldacci Cristina Santoro Antonio Chistolini SECONDARY PROPHYLAXIS OF VENOUS THROMBOEMBOLISM (VTE) WITH LOW DOSE APIXABAN OR RIVAROXABAN: RESULTS FROM A PATIENT POPULATION WITH MORE THAN 2 YEARS OF MEDIAN FOLLOW-UP Mediterranean Journal of Hematology and Infectious Diseases dose-reduced Deep vein thrombosis Direct oral anticoagulants (DOACs) Venous thromboembolism secondary prophylaxis VTE recurrence Bleeding adverse events |
| title | SECONDARY PROPHYLAXIS OF VENOUS THROMBOEMBOLISM (VTE) WITH LOW DOSE APIXABAN OR RIVAROXABAN: RESULTS FROM A PATIENT POPULATION WITH MORE THAN 2 YEARS OF MEDIAN FOLLOW-UP |
| title_full | SECONDARY PROPHYLAXIS OF VENOUS THROMBOEMBOLISM (VTE) WITH LOW DOSE APIXABAN OR RIVAROXABAN: RESULTS FROM A PATIENT POPULATION WITH MORE THAN 2 YEARS OF MEDIAN FOLLOW-UP |
| title_fullStr | SECONDARY PROPHYLAXIS OF VENOUS THROMBOEMBOLISM (VTE) WITH LOW DOSE APIXABAN OR RIVAROXABAN: RESULTS FROM A PATIENT POPULATION WITH MORE THAN 2 YEARS OF MEDIAN FOLLOW-UP |
| title_full_unstemmed | SECONDARY PROPHYLAXIS OF VENOUS THROMBOEMBOLISM (VTE) WITH LOW DOSE APIXABAN OR RIVAROXABAN: RESULTS FROM A PATIENT POPULATION WITH MORE THAN 2 YEARS OF MEDIAN FOLLOW-UP |
| title_short | SECONDARY PROPHYLAXIS OF VENOUS THROMBOEMBOLISM (VTE) WITH LOW DOSE APIXABAN OR RIVAROXABAN: RESULTS FROM A PATIENT POPULATION WITH MORE THAN 2 YEARS OF MEDIAN FOLLOW-UP |
| title_sort | secondary prophylaxis of venous thromboembolism vte with low dose apixaban or rivaroxaban results from a patient population with more than 2 years of median follow up |
| topic | dose-reduced Deep vein thrombosis Direct oral anticoagulants (DOACs) Venous thromboembolism secondary prophylaxis VTE recurrence Bleeding adverse events |
| url | https://www.mjhid.org/mjhid/article/view/5567 |
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