Cohort study
Effectiveness and Safety of Rivaroxaban and Low Molecular Weight Heparin in Cancer-Associated Venous Thromboembolism
- Retrospective cohort study
- propensity score-overlap weighting
- electronic health records
Authors' conclusion
Among active cancer patients experiencing VTE and not at high risk of bleeding on DOACs, rivaroxaban was associated with a reduced risk of recurrent VTE versus LMWHs at 3 and 6 months but not 12 months.
Study context
- Population
- Adults with active cancer (not at high risk of DOAC bleeding) and an index cancer-associated venous thromboembolism (VTE), 2012–202029.5% rivaroxaban, 70.5% low molecular weight heparin (LMWH)
- Participants
- 3,708 adults
- Exposure
- Rivaroxaban vs LMWH
Main finding
Recurrent VTE · 3 months
Hazard ratio
0.69
95% CI 0.51–0.92
By group
Rivaroxaban vs LMWH
HR 0.69 (95% CI 0.51–0.92)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause mortality · 3 months | 1.07 (0.85–1.35) | |
| Recurrent VTE · 6 months | 0.74 (0.57–0.97) | |
| 0.512Hazard ratio (log scale) |
Time on anticoagulation
Recurrent VTE · 6 months
- No reduction in bleeding-related hospitalizations or all-cause mortality at 6 months
Recurrent VTE, bleeding-related hospitalizations, all-cause mortality · 12 months
- No difference between cohorts for any outcome
Safety
| Outcome | HR (95% CI) | |
|---|---|---|
| Bleeding-related hospitalizations · 3 months | 0.79 (0.55–1.13) | |
| 0.512Hazard ratio (log scale) |
Original publication
Effectiveness and Safety of Rivaroxaban and Low Molecular Weight Heparin in Cancer-Associated Venous Thromboembolism. JACC CardioOncol. Published 7 February 2023. doi:10.1016/j.jaccao.2022.10.014
Summarised from the published abstract; every number is checked against it