Effectiveness and safety of the direct oral anticoagulant in acute distal deep vein thrombosis: From the prospective multicenter observational study, J'xactly, in Japan

Phlebology. 2023 Feb;38(1):4-15. doi: 10.1177/02683555221141310. Epub 2022 Nov 26.

Abstract

Objectives: We assessed the effectiveness and safety of rivaroxaban in patients with isolated distal deep vein thrombosis (IDDVT).

Methods: Symptomatic venous thromboembolism (VTE) and major bleeding were assessed.

Results: Of 1016 patients with acute symptomatic/asymptomatic DVT and/or pulmonary embolism treated with rivaroxaban, 288 had IDDVT and 294 had proximal DVT (pDVT). The IDDVT group had fewer patients on the higher rivaroxaban dose (30 mg/day) (42.7% vs. 66.0%) and a shorter treatment duration (135.5 vs 369.5 days) than the pDVT group. VTE recurrence occurred in 14 and 11 patients with IDDVT and pDVT, respectively (2.89% vs. 2.29% per patient-year; p = 0.534). Major bleeding was less frequent in the IDDVT group (1.55% vs. 4.53% per patient-year; p = 0.044). Comparable effectiveness and safety were observed with 15 and 30 mg/day rivaroxaban in the IDDVT group.

Conclusions: Short-term, low-dose rivaroxaban seems safe and effective for IDDVT treatment.

Keywords: Deep vein thrombosis; isolated distal deep vein thrombosis; pulmonary embolism; real-world survey; rivaroxaban.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Acute Disease
  • Anticoagulants / adverse effects
  • Hemorrhage / chemically induced
  • Humans
  • Japan
  • Prospective Studies
  • Pulmonary Embolism* / drug therapy
  • Risk Factors
  • Rivaroxaban / adverse effects
  • Venous Thromboembolism*
  • Venous Thrombosis* / drug therapy

Substances

  • Rivaroxaban
  • Anticoagulants