Efficacy of rivaroxaban in prevention of post-thrombotic syndrome: A systematic review and meta-analysis

Post‐thrombotic syndrome in patients with venous thromboembolism treated with dabigatran or warfarin: A long‐term cross‐sectional follow‐up of RE‐COVER study patients

“…Adjusted OR for PTS in the DOAC‐treated patients was 0.46 (95% CI 0.33–0.63) compared to the patients treated with warfarin, concluding that the use of the DOACs may offer a more favorable prognosis in terms of PTS development. Finally, two recent meta‐analyses found that the use of rivaroxaban for the treatment of DVT was associated with about 50% reduction of PTS risk compared to conventional vitamin K antagonists, but few randomized clinical trials were included 24,26 . We are not aware of published studies comparing the DOACs apixaban and edoxaban with warfarin on the risk of PTS development, but the HOKUSAI POST VTE study is ongoing and will explore the long‐term outcomes after edoxaban compared to warfarin (ClinicalTrials.gov Identifier: NCT03757481).…”

“…Finally, two recent meta-analyses found that the use of rivaroxaban for the treatment of DVT was associated with about 50% reduction of PTS risk compared to conventional vitamin K antagonists, but few randomized clinical trials were included. 24,26 We are not aware of published studies comparing the DOACs apixaban and edoxaban with warfarin on the risk of PTS development, but the HOKUSAI POST VTE study is ongoing and will explore the long-term outcomes after edoxaban compared to warfarin (ClinicalTrials.gov Identifier: NCT03757481). Good quality anticoagulation with warfarin, as measured by the proportion of time that INR is in the therapeutic range, also seems to reduce the risk of PTS compared with subtherapeutic anticoagulation.…”

“…16 Several studies have suggested that the direct factor Xa inhibitor rivaroxaban compared to warfarin reduces the risk of PTS after DVT. [17][18][19][20][21][22][23][24][25][26] To our knowledge, no studies thus far have compared the effect of warfarin to that of the other DOACs, including apixaban, dabigatran, or edoxaban, on PTS occurrence. Hence, our aim was to compare the long-term prevalence of PTS, recurrent VTE, and health-related quality of life (HRQoL) after acute DVT and pulmonary embolism (PE) among patients randomized to treatment with dabigatran or warfarin in the subpopulations of the RE-COVER studies that were recruited in Canada, Norway, and Sweden.…”

“…Based on previous knowledge of the association between intensity of anticoagulation and the prevalence of PTS, it has been proposed that DOACs may reduce the occurrence and severity of PTS 16 . Several studies have suggested that the direct factor Xa inhibitor rivaroxaban compared to warfarin reduces the risk of PTS after DVT 17–26 . To our knowledge, no studies thus far have compared the effect of warfarin to that of the other DOACs, including apixaban, dabigatran, or edoxaban, on PTS occurrence.…”

Risk Factors for Post-Thrombotic Syndrome in Patients With a First Proximal Deep Venous Thrombosis Treated With Direct Oral Anticoagulants

“…PTS can dramatically reduce quality of life and increase healthcare costs. [8][9][10] Two recently published metaanalyses 11,12 have suggested that rivaroxaban may be more efficacious than vitamin K antagonists (VKAs) combined with low molecular weight heparin (LMWH) in reducing the risk of developing PTS. Nevertheless, current guidelines and/or consensus/statements of experts offer no definitive treatment for PTS.…”