Safety and effectiveness of rivaroxaban and apixaban in patients with venous thromboembolism: a nationwide study. Issue 4 (26th June 2018)

• Record Type: Journal Article
• Authors: Sindet-Pedersen, Caroline; Staerk, Laila; Pallisgaard, Jannik Langtved; Gerds, Thomas Alexander; Berger, Jeffrey S; Torp-Pedersen, Christian; Gislason, Gunnar H; Olesen, Jonas Bjerring
• Is Part Of: European heart journal. Volume 4:Issue 4(2018:Oct.)
• Page Start: 220
• Page End: 227
• Publication Date: 2018-06-26
• Subjects: Venous thromboembolism -- Anticoagulation -- Apixaban -- Rivaroxaban -- Non-vitamin K antagonist oral anticoagulants -- Bleeding; Cardiovascular pharmacology -- Periodicals; 615.71
• DOI: 10.1093/ehjcvp/pvy021
• Languages: English
• ISSNs: 2055-6837

Abstract

Abstract: Aims: To investigate the risk of all-cause mortality, recurrent venous thromboembolism (VTE), and hospitalized bleeding in patients with VTE treated with either rivaroxaban or apixaban. Methods and results: Using Danish nationwide registries, patients with VTE treated with rivaroxaban or apixaban in the period from 1 January 2015 to 30 June 2017 were identified. Standardized absolute risks were estimated based on outcome-specific Cox regression models, adjusted for potential confounders. A total of 8187 patients were included in the study, of which 1504 (18%) were treated with apixaban [50% males, median age 70 years; interquartile range (IQR) 56–80] and 6683 (82%) were treated with rivaroxaban (55% males, median age 67 years; IQR 53–76). The 180 days risk of all-cause mortality was 5.08% [95% confidence interval (95% CI) 4.08% to 6.08%)] in the apixaban group and 4.60% (95% CI 4.13% to 5.18%) in the rivaroxaban group [absolute risk difference: −0.48% (95% CI −1.49% to 0.72%)]. The 180 days risk of recurrent VTE was 2.16% (95% CI 1.49% to 2.88%) in the apixaban group and 2.22% (95% CI 1.89% to 2.52%) in the rivaroxaban group [absolute risk difference of 0.06% (95% CI −0.72% to 0.79%)]. The 180 days risk of hospitalized bleeding was 1.73% (95% CI 1.22% to 2.35%) for patients in the apixaban group and 1.89% (95% CI 1.56% to 2.20%) in the rivaroxaban group [absolute risk difference: 0.16% (95% CI −0.59% to 0.81%)]. Conclusion: In a nationwide cohort of 8187 patients with VTE treated with rivaroxaban or apixaban, there were no significant differences in the risks of all-cause mortality, recurrent VTE, or hospitalized bleeding.