Nakamura Mashio, Fukuda Ikuo, Yamada Norikazu, Takayama Morimasa, Maeda Hideaki, Yamashita Takeshi, Ikeda Takanori, Mo Makoto, Yamazaki Tsutomu, Okumura Yasuo, Hirayama Atsushi
Nakamura Medical Clinic Kuwana Japan.
Department of Cardiology, Keimeikai Yokawa Hospital Miki Japan.
Circ Rep. 2023 Mar 24;5(4):144-151. doi: 10.1253/circrep.CR-23-0008. eCollection 2023 Apr 10.
Rivaroxaban, a direct oral anticoagulant, is used as a first-line treatment to prevent venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE). However, whether 21 days is optimal for the initial treatment duration has not been investigated. In this subanalysis of the prospective multicenter observational J'xactly study, which included 1,039 Japanese patients with acute symptomatic/asymptomatic DVT/PE who were prescribed rivaroxaban, the VTE recurrence rate and incidence of bleeding complications were assessed in 667 patients who underwent intensive rivaroxaban treatment (15 mg, twice daily) for a short (1-8 days), intermediate (9-16), or standard (17-24) duration. The short treatment duration group showed a tendency for increased VTE recurrence/aggravation compared with the standard treatment duration group (6.10% vs. 2.60% per patient-year). The intermediate treatment duration group showed a higher incidence of bleeding events than the standard treatment duration group (9.34% vs. 2.16% per patient-year), without major differences in patient characteristics between the groups. In this subanalysis of the real-world observational J'xactly study of VTE treatment and prevention in Japanese patients with acute symptomatic/asymptomatic DVT/PE, the standard initial intensive rivaroxaban treatment duration (17-24 days) appeared to be safe and effective, providing important insights into the clinical outcomes of the initial rivaroxaban treatment duration in this population.
利伐沙班是一种直接口服抗凝剂，用作预防静脉血栓栓塞（VTE）的一线治疗药物，包括深静脉血栓形成（DVT）和肺栓塞（PE）。然而，初始治疗持续21天是否为最佳疗程尚未得到研究。在这项前瞻性多中心观察性J'xactly研究的亚分析中，纳入了1039例接受利伐沙班治疗的日本急性症状性/无症状DVT/PE患者，对667例接受短期（1 - 8天）、中期（9 - 16天）或标准疗程（17 - 24天）利伐沙班强化治疗（15毫克，每日两次）的患者评估了VTE复发率和出血并发症发生率。与标准疗程组相比，短疗程组显示VTE复发/加重有增加趋势（每患者年6.10%对2.60%）。中期疗程组的出血事件发生率高于标准疗程组（每患者年9.34%对2.16%），两组患者特征无重大差异。在这项针对日本急性症状性/无症状DVT/PE患者VTE治疗和预防的真实世界观察性J'xactly研究的亚分析中，标准的初始利伐沙班强化治疗疗程（17 - 24天）似乎是安全有效的，为该人群初始利伐沙班治疗疗程的临床结局提供了重要见解。
