1. Effectiveness and safety of apixaban and rivaroxaban for acute venous thromboembolism therapy in patients with extremes in bodyweight.
- Author
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Wysokinski WE, Froehling DA, Houghton DE, McBane RD, Vlazny DT, Bott-Kitslaar DM, Kuczmik W, Sutkowska K, Bator K, Hodge DO, Peterson LG, and Casanegra AI
- Subjects
- Acute Disease, Anticoagulants administration & dosage, Anticoagulants adverse effects, Disease Management, Drug Therapy, Combination, Factor Xa Inhibitors administration & dosage, Factor Xa Inhibitors adverse effects, Health Care Surveys, Hemorrhage etiology, Humans, Pyrazoles administration & dosage, Pyrazoles adverse effects, Pyridones administration & dosage, Pyridones adverse effects, Registries, Rivaroxaban administration & dosage, Rivaroxaban adverse effects, Venous Thromboembolism complications, Venous Thromboembolism diagnosis, Anticoagulants therapeutic use, Body Weight, Factor Xa Inhibitors therapeutic use, Pyrazoles therapeutic use, Pyridones therapeutic use, Rivaroxaban therapeutic use, Venous Thromboembolism drug therapy, Venous Thromboembolism epidemiology
- Abstract
Objectives: To investigate the association of extremes in bodyweight (EBW) and outcomes in patients with acute venous thromboembolism (VTE). Recurrent VTE, major bleeding, and clinically relevant non-major bleeding were compared between patients with bodyweight <60 kg, 60-120 kg, and >120 kg., Methods: Consecutive patients enrolled in the Mayo Clinic VTE Registry (03/28/2013-8/31/2019) with acute VTE were followed prospectively. Patient status was assessed in person, by mailing a written questionnaire, or by a scripted phone interview., Results: Among 2577 patients with weight ranging from 27.0 kg to 263.2 kg, 2123 (82%) had a bodyweight between 60 and 120 kg, 223 (8.7%) had bodyweight < 60 kg, and 230 (8.9%) had bodyweight >120 kg. Patients with bodyweight <60 kg treated with DOACs had higher 3- and 6-month incidence of major bleeding compared to the bodyweight 60-120kg group (4.4% vs 1.1%, P = .03, and 4.4% vs 1.4%, P = .05, respectively). Patients with bodyweight >120 kg and cancer on rivaroxaban had higher VTE recurrence compared to bodyweight 60-120kg group (P = .01)., Conclusions: Treatment of acute VTE is associated with a higher incidence of bleeding in patients with bodyweight <60 kg. A higher VTE recurrence rate occurred only in cancer patients with bodyweight >120 kg on rivaroxaban., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2020
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