Six Additional Weeks of Rivaroxaban Reduces Recurrent VTE

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Risk for recurrent venous thromboembolism reduced for patients with isolated distal DVT receiving six additional weeks of rivaroxaban

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Nov. 30, 2022 (HealthDay News) — For patients with isolated distal deep venous thrombosis (DVT), six additional weeks of rivaroxaban after an initial six-week course of treatment reduces the risk for recurrent venous thromboembolism, according to a study published online Nov. 23 in The BMJ.

Walter Ageno, M.D., from the University of Insubria in Italy, and colleagues compared two different treatment durations of rivaroxaban in 402 adults with symptomatic isolated distal DVT in a randomized trial. Participants received standard-dose rivaroxaban for six weeks and were then randomly assigned to rivaroxaban 20 mg or placebo once daily for six weeks (200 and 202 patients, respectively). Patients were followed up for 24 months from study inclusion.

In 40 and 43 percent of patients in the additional rivaroxaban and placebo groups, respectively, isolated distal DVT was unprovoked. The researchers found that the primary efficacy outcome of recurrent venous thromboembolism during follow-up occurred in 11 and 19 percent of patients in the rivaroxaban and placebo arms, respectively (relative risk, 0.59). Recurrent isolated distal DVT occurred in 8 and 15 percent of patients in the rivaroxaban and placebo arms, respectively. Proximal DVT or pulmonary embolism occurred in 3 and 4 percent of patients, respectively. There were no major bleeding events reported.

“This benefit was mainly driven by recurrent isolated distal DVT, maintained during the 24-month follow-up, and was consistent among patient subgroups,” the authors write.

The study was partially funded by Bayer Italy. Two authors disclosed financial ties to pharmaceutical companies, including Bayer.

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