Safety and effectiveness of rivaroxaban and apixaban in patients with venous thromboembolism - a nationwide study.
Eur Heart J Cardiovasc Pharmacother. 2018 Jun 26;:
Authors: Sindet-Pedersen C, Staerk L, Langtved Pallisgaard J, Gerds TA, Berger JS, Torp-Pedersen C, Gislason GH, Bjerring Olesen J
Abstract
Aim: To investigate the risk of all-cause mortality, recurrent 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 January 1st 2015 to June 30th 2017 were identified. Standardized absolute risks were estimated based on outcome-specific Cox regression models, adjusted for potential confounders. A total of 8,187 patients were included in the study, of which 1,504 (18%) were treated with apixaban (50% males, median age 70 years; inter quartile range (IQR) 56-80) and 6,683 (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%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 8,187 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.
PMID: 29945162 [PubMed - as supplied by publisher]