Original Articles
Vol. 16 No. 1 (2024): Review Articles, Original Article, Scientific Letter, Case Reports Letter to the Editor
https://doi.org/10.4084/MJHID.2024.020

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

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Received: November 21, 2023
Accepted: January 20, 2024
Published: February 29, 2024
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dose-reduced, Deep vein thrombosis, Direct oral anticoagulants (DOACs), Venous thromboembolism secondary prophylaxis, VTE recurrence, Bleeding adverse events, VTE, Pulmonary Embolism, Apixaban, Rivaroxaban

Authors

Alessandro Laganà
a:1:{s:5:"en_US";s:28:"Sapienza Università di Roma";}, Italy.
Giovanni Manfredi Assanto
Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy, Italy.
Chiara Masucci
Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy, Italy.
Mauro Passucci
Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy, Italy.
Livia Donzelli
Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy, Italy.
Alessandra Serrao
Haematology and Stem Cell Transplant Unit, A. O. San Camillo Forlanini (L.R.), Rome, Italy, Italy.
Erminia Baldacci
Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy, Italy.
Cristina Santoro
Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy, Italy.
Antonio Chistolini
chistolini@bce.uniroma1.it
Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy, 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.

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Ethics Approval

anticogulation, thrombosis and hemostasis, Deep vein thrombosis

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How to Cite



“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” (2024) Mediterranean Journal of Hematology and Infectious Diseases, 16(1), p. e2024020. doi:10.4084/MJHID.2024.020.
Copyright (c) 2024 Alessandro Laganà, Giovanni Manfredi Assanto, Chiara Masucci, Mauro Passucci, Livia Donzelli, Alessandra Serrao, Erminia Baldacci, Cristina Santoro, Antonio Chistolini Creative Commons License

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