Key result
Rivaroxaban for DVT is linked to a ~33% shorter hospital stay versus standard anticoagulation.
Why the study?
Does rivaroxaban reduce healthcare resource use and hospital length of stay compared to standard anticoagulation in patients with deep vein thrombosis?
Observational (n=2,248)
Does rivaroxaban reduce healthcare resource use and hospital length of stay compared to standard anticoagulation in patients with deep vein thrombosis?
Effect estimate: geometric means ratio 0.67 (95% CI 0.61-0.74)
Absolute Event Rate: 5.4% vs 8%
p-value: p=< 0.001
In routine clinical practice, DVT treatment with rivaroxaban is associated with a significantly shorter hospital length of stay compared to standard anticoagulation.
Shorter DVT hospitalization with rivaroxaban may lower resource use; leaves open whether effects are causal or apply beyond this cohort.
INTRODUCTION: The non-interventional XALIA study compared the safety and effectiveness of rivaroxaban with standard anticoagulation for the treatment of venous thromboembolism in routine clinical practice. This substudy assessed the effect of treatment with rivaroxaban on healthcare resource use, hospital length of stay (LOS) and frequency of hospitalisation. METHODS: In XALIA, patients aged ≥18 years scheduled to receive ≥3 months of rivaroxaban or standard anticoagulation treatment for deep vein thrombosis (DVT) were eligible. Treatment decisions were at the physician's discretion. Healthcare resource use, including hospital admission for the index DVT and initial LOS, was documented. The main analyses in this substudy were conducted in a 1:1 propensity score-matched set (PMS) of patients, with adjustment for cancer at baseline. RESULTS: In the PMS analysis, 1124 rivaroxaban-treated patients and 1124 standard anticoagulation-treated patients were included. Baseline characteristics were similar between groups (mean age 60.8 years vs. 61.2 years, DVT only rates of 89.7% vs. 90.2% and cancer rates of 8.4% vs. 8.5%, respectively). Of these, 433/1124 (38.5%) rivaroxaban-treated patients and 438/1124 (39.0%) standard anticoagulation-treated patients were hospitalised. Index event LOS in the PMS analysis was a least-squares mean of 2.6 days shorter with rivaroxaban vs. standard anticoagulation (5.4 vs. 8.0 days; geometric means ratio = 0.67 [95% confidence interval 0.61-0.74, P < 0.001]). CONCLUSIONS: In XALIA, hospital LOS was shorter with rivaroxaban than with standard anticoagulation, consistent with the phase III study results. DVT treatment with rivaroxaban in routine clinical practice may reduce the cost per patient vs. standard anticoagulation.
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Mantovani et al. (2018) conducted an observational in Deep vein thrombosis (n=2,248). Rivaroxaban vs. Standard anticoagulation was evaluated on Index event hospital length of stay (LOS) (geometric means ratio 0.67, 95% CI 0.61-0.74, p=< 0.001). Rivaroxaban treatment for deep vein thrombosis was associated with a shorter hospital length of stay compared to standard anticoagulation (5.4 vs. 8.0 days; geometric means ratio 0.67, P<0.001).
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