Duration of Initial Intensive Rivaroxaban Therapy for Patients With Venous Thromboembolism ― Subanalysis of the J’xactly Study ―
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- Nakamura Mashio
- Nakamura Medical Clinic
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- Fukuda Ikuo
- Department of Cardiology, Keimeikai Yokawa Hospital
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- Yamada Norikazu
- Department of Cardiology, Kuwana City Medical Center
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- Takayama Morimasa
- Department of Cardiology, Sakakibara Heart Institute
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- Maeda Hideaki
- Department of Heart and Vascular Center, Ukima Central Hospital
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- Yamashita Takeshi
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Ikeda Takanori
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
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- Mo Makoto
- Department of Cardiovascular Surgery, Yokohama Minami Kyosai Hospital
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- Yamazaki Tsutomu
- Innovation and Research Support Center, International University of Health and Welfare
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- Okumura Yasuo
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
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- Hirayama Atsushi
- Department of Cardiology, Osaka Police Hospital
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Description
<p>Background: Rivaroxaban, a direct oral anticoagulant, is used as a first-line treatment to prevent venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE). However, whether 21 days is optimal for the initial treatment duration has not been investigated.</p><p>Methods and Results: In this subanalysis of the prospective multicenter observational J’xactly study, which included 1,039 Japanese patients with acute symptomatic/asymptomatic DVT/PE who were prescribed rivaroxaban, the VTE recurrence rate and incidence of bleeding complications were assessed in 667 patients who underwent intensive rivaroxaban treatment (15 mg, twice daily) for a short (1–8 days), intermediate (9–16), or standard (17–24) duration. The short treatment duration group showed a tendency for increased VTE recurrence/aggravation compared with the standard treatment duration group (6.10% vs. 2.60% per patient-year). The intermediate treatment duration group showed a higher incidence of bleeding events than the standard treatment duration group (9.34% vs. 2.16% per patient-year), without major differences in patient characteristics between the groups.</p><p>Conclusions: In this subanalysis of the real-world observational J’xactly study of VTE treatment and prevention in Japanese patients with acute symptomatic/asymptomatic DVT/PE, the standard initial intensive rivaroxaban treatment duration (17–24 days) appeared to be safe and effective, providing important insights into the clinical outcomes of the initial rivaroxaban treatment duration in this population.</p>
Journal
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- Circulation Reports
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Circulation Reports 5 (4), 144-151, 2023-04-10
The Japanese Circulation Society
