OBJECTIVE: Our main objective is to explore the effectiveness and safety of rivaroxaban and edoxaban in treating lower extremity DVT.
METHODS: We conducted a retrospective study involving 406 patients subjected to DVT treatment using direct oral anticoagulants (edoxaban and rivaroxaban) at our hospital. We recruited adult patients (aged 18 years and more) diagnosed with lower extremity DVT and received treatment with either rivaroxaban or edoxaban as the primary anticoagulant therapy for DVT. We excluded patients who received treatment with other anticoagulant medications (warfarin and heparin) as the primary therapy for DVT.
RESULTS: The groups showed statistically significant differences in red blood cell count and hemoglobin levels, with the edoxaban group having high values. However, the 2 groups observed no statistically significant differences in creatinine clearance, white blood cell count, platelet count, C-reactive protein, and D-dimer levels. The difference in the incidence of pulmonary embolism between the 2 groups was statistically significant (P value < 0.001). The edoxaban group had fewer pulmonary embolism patients than the rivaroxaban group. The reduction in recurrent thrombosis was significantly higher in the rivaroxaban group compared to the edoxaban group. There were no significant differences in the major bleeding at various sites across the 2 treatment groups (P > 0.05).
CONCLUSIONS: Rivaroxaban\'s pharmacokinetic profile includes rapid absorption and a relatively short half-life. It means that once administered, rivaroxaban quickly reaches its peak concentration in the blood and is subsequently eliminated from the body within a relatively short period. Edoxaban\'s pharmacokinetic profile may include slower absorption and a longer half-life than rivaroxaban. It can result in a slower rate of achieving peak concentration and a more prolonged presence in the bloodstream. These results emphasize the need for careful consideration of anticoagulant therapy in patients with underlying cancer and underscore the importance of managing risks while providing adequate anticoagulation to prevent thrombotic events.
目的:我们的主要目的是探讨利伐沙班和依多沙班治疗下肢深静脉血栓的有效性和安全性。
方法:我们进行了一项回顾性研究,纳入了406名在我院接受DOACs(依多沙班和利伐沙班)治疗的DVT患者。我们招募了诊断为下肢深静脉血栓形成的成年患者(18岁及以上),并接受了利伐沙班或依多沙班作为DVT的主要抗凝治疗。我们排除了接受其他抗凝药物(华法林肝素)作为DVT主要治疗的患者。
结果:两组在红细胞计数和血红蛋白水平上有统计学意义的差异,Edoxaban组具有很高的价值。然而,两组肌酐清除率无统计学差异,白细胞计数,血小板计数,C反应蛋白,和D-二聚体水平。两组间PE发生率差异有统计学意义(P值<0.001)。依多沙班组的PE患者少于利伐沙班组。利伐沙班组复发性血栓形成的减少明显高于依多沙班组。两个治疗组不同部位的大出血没有显著差异(p>0.05)。
结论:利伐沙班的药代动力学特征包括快速吸收和相对较短的半衰期。这意味着一旦管理,利伐沙班在血液中迅速达到其峰值浓度,随后在相对较短的时间内从体内排出。依度沙班的药代动力学特征可能包括比利伐沙班更慢的吸收和更长的半衰期。它可以导致较慢的速率达到峰值浓度和更长时间存在于血流中。这些结果强调需要仔细考虑潜在癌症患者的抗凝治疗,并强调在提供足够的抗凝以预防血栓事件的同时管理风险的重要性。