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Thromb Haemost 2016; 116(03): 472-479
DOI: 10.1160/TH16-03-0209
Coagulation and Fibrinolysis
Schattauer GmbH

Rivaroxaban for the treatment of venous thromboembolism

The SWIss Venous ThromboEmbolism Registry (SWIVTER)
Nils Kucher
1   Swiss Cardiovascular Center, Bern University Hospital, Bern, Switzerland
,
Drahomir Aujesky
2   Division of General Internal Medicine, Bern University Hospital, Bern, Switzerland
,
Jürg H. Beer
3   Department of Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland
,
Lucia Mazzolai
4   Clinic of Angiology, University Hospital Lausanne, Lausanne, Switzerland
,
Thomas Baldi
5   Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
,
Martin Banyai
6   Department of Internal Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland
,
Daniel Hayoz
7   Department of Internal Medicine, Cantonal Hospital Fribourg, Fribourg, Switzerland
,
Thomas Kaeslin
8   Department of Internal Medicine, Cantonal Hospital Obwalden, Sarnen, Switzerland
,
Wolfgang Korte
9   Department of Internal Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
,
Robert Escher
10   Department of Internal Medicine, Regional Hospital Burgdorf, Burgdorf, Switzerland
,
Marc Husmann
11   Clinic of Angiology, University Hospital Zurich, Zurich, Switzerland
,
Beat Frauchiger
12   Department of Internal Medicine, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
,
Iris Baumgartner
1   Swiss Cardiovascular Center, Bern University Hospital, Bern, Switzerland
,
David Spirk
13   Institute of Pharmacology, University Bern, Bern, Switzerland
› Author Affiliations Financial support: This study was funded by the International Society on Thrombosis and Haemostasis (ISTH) 2007 Presidential Fund, Sanofi-Aventis (Suisse) SA, Vernier, Bayer (Schweiz) AG, Zurich, Pfizer AG, Zurich, and Bristol-Myers Squibb AG, Cham, Switzerland.
Further Information

Publication History

Received: 14 March 2016

Accepted after major revision: 17 May 2016

Publication Date:
29 November 2017 (online)

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Summary

We investigated three-month clinical outcomes in patients with venous thromboembolism (VTE) treated with rivaroxaban or conventional anticoagulation in routine clinical practice. Between November 2012 and February 2015, 2,062 consecutive patients with VTE from 11 acute care hospitals in Switzerland were enrolled in the SWIss Venous ThromboEmbolism Registry (SWIVTER). Overall, 417 (20 %) patients were treated with rivaroxaban. In comparison to 1,645 patients on conventional anticoagulation, patients on rivaroxaban were younger (56 ± 18 vs. 65 ± 17 years; p<0.001), less often had pulmonary embolism (38 % vs 66 %; p<0.001), hypertension (26 % vs 41 %; p<0.001), cancer (10 % vs 28 %; p<0.001), congestive heart failure (10 % vs 17 %; p=0.001), diabetes (8 % vs 15 %; p<0.001), chronic lung disease (7 % vs 13 %; p=0.001), renal insufficiency (7 % vs 13 %; p=0.001), recent surgery (7 % vs 14 %; p<0.001), and acute coronary syndrome (1 % vs 4 %; p=0.009). VTE reperfusion therapy was more frequently used (28 % vs 9 %; p<0.001) and indefinite-duration anticoagulation treatment less often planned (26 % vs 39 %; p<0.001), respectively. In the propensity score-adjusted population, the risk of recurrent VTE was similar in patients on rivaroxaban vs conventional anticoagulation (1.2 % vs 2.1 %, hazard ratio [HR] 0.55, 95 % confidence interval [CI] 0.18–1.65; p=0.29); the risk of major bleeding was also similar, respectively (0.5 % vs 0.5 %, HR 1.00, 95 %CI 0.14–7.07; p=1.00). Conventional anticoagulation is still frequently used for the treatment of VTE, particularly in the elderly and those with comorbidities. Early clinical outcomes were comparable between propensity score-adjusted patient populations on rivaroxaban and conventional anticoagulation.

Keywords

Anticoagulation - rivaroxaban - venous thromboembolism
 

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