Abstract
Background
Rivaroxaban, a non-vitamin K antagonist oral anticoagulant, has become widely used for the management of venous thromboembolism (VTE) in adult patients. However, few trials have explored the efficacy and safety of rivaroxaban in VTE patients over 80 years of age. This necessitates further real-world studies of rivaroxaban across elderly populations.
Methods
We performed a retrospective single center study involving extremely aged VTE sufferers treated with rivaroxaban. The sample comprised 121 patients newly initiated on rivaroxaban diagnosed between January 2018 and January 2020. Patients were followed up for no less than 2 years. The effectiveness outcome was the disappearance of thromboembolism. The safety outcome was the incidence of major bleeding events. Comorbidities and complications were recorded throughout the entire study.
Results
The efficacy outcome occurred in 114 of 121 patients (94.21%) and the safety outcome occurred in 12 of 121 patients (9.91%). Increased hemorrhages were observed in patients with infection (15.15% vs 7.80%), but no significant difference was observed due to limited sample size (P=0.3053). Patients with an age-adjusted Charlson comorbidity index score higher than 6 points exhibited higher bleeding rates (14.08% vs 4.00%; P=0.0676) and lower thrombus cure rates (88.73% vs 100%; P=0.0203).
Key conclusions
Patients with infection should be more careful of bleeding events during rivaroxaban therapy. An age-adjusted Charlson comorbidity index score higher than 6, which predicted poor survival, indicated inferior safety and efficacy of rivaroxaban.
Aim
To investigate the efficacy and safety of Rivaroxaban in an aged venous thromboembolism patient population under real-world conditions.
Data Sharing Statement
The raw data required to reproduce these findings cannot be shared at this time as the data also forms part of an ongoing study. Data are, however, available from the authors upon reasonable request and with permission of the corresponding author (Wangshu Dai).
Ethics Approval
All methods of this study were carried out in accordance with the guidelines of the Declaration of Helsinki and were approved by the Ethics Committee of Nanjing Drum Tower Hospital (2021-195-02).
Acknowledgments
The abstract of this paper was presented at the 18th Congress of the European Geriatric Medicine Society as a poster presentation talk with interim findings. The poster’s abstract was published in ‘Poster Abstracts’ in European Geriatric Medicine (https://doi.org/10.1007/s41999-022-00711-8).
Disclosure
The authors declare that they have no competing interests in this work.