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June 12, 2026Clinical and Applied Thrombosis/HemostasisOpen Access

Rivaroxaban cuts VTE recurrence ~12% and all-cause mortality vs LMWH in cancer-associated VTE.

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Why the study?

Venous thromboembolism is a serious complication in cancer patients, prompting an evaluation of the efficacy and safety of rivaroxaban compared to LMWHs in treating cancer-associated VTE.

Does rivaroxaban reduce VTE recurrence and all-cause mortality compared to LMWH in adults with cancer-associated VTE?

Comparison

Rivaroxaban vs LMWHs

Design

Systematic review and meta-analysis

Key result

Rivaroxaban significantly reduced the risk of VTE recurrence (RR 0.88; 95% CI 0.78-0.99; P=0.03) and all-cause mortality compared to LMWH in adults with cancer-associated VTE.

Authors

ZAZahabia AdnanSHSyed Ibad HussainAJAmna Amir Jalal

Discussion

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Overview

May favor rivaroxaban over LMWH to reduce VTE recurrence in cancer patients; leaves open practice change pending confirmatory RCTs.

Key Points

  • This analysis investigates the effectiveness and safety of rivaroxaban compared to low molecular weight heparin for treating cancer-associated venous thromboembolism.
  • Systematic review and meta-analysis following PRISMA guidelines
  • Included 25 studies with a total of 19,153 cancer patients
  • Pooled risk ratios using a random-effects model
  • Rivaroxaban reduced the risk of VTE recurrence (RR = 0.88; 95% CI: 0.78-0.99; P = 0.03)
  • Rivaroxaban decreased all-cause mortality (RR = 0.83; 95% CI: 0.69-0.99; P = 0.04)
  • No significant differences noted in other outcomes; GRADE showed evidence certainty varied from high to very low.

Study Design

Type

Meta-Analysis (n=19,153)

Structured PICO

Does rivaroxaban reduce VTE recurrence and all-cause mortality compared to LMWH in adults with cancer-associated VTE?

P
Population
19,153 adults with cancer-associated venous thromboembolism across 25 studies comparing rivaroxaban to low-molecular-weight heparins.
I
Intervention
Rivaroxaban
C
Comparator
Low-molecular-weight heparins (LMWHs)
O
Outcome
VTE recurrence and all-cause mortalityhard clinical

Main Result

Relative Risk: 0.88 (95% CI 0.78–0.99)

p-value: p=0.03

In adults with cancer-associated VTE, rivaroxaban significantly reduces VTE recurrence and all-cause mortality compared to LMWH.

Limitations

  • Evidence certainty ranged from high to very low
  • Further large-scale RCTs are warranted to confirm safety profile

Cite This Study

Adnan et al. (2026) conducted a meta-analysis in Cancer-associated venous thromboembolism (n=19,153). Rivaroxaban vs. Low-molecular-weight heparins (LMWHs) was evaluated on VTE recurrence (RR 0.88, 95% CI 0.78-0.99, p=0.03). Rivaroxaban significantly reduced the risk of VTE recurrence (RR 0.88; 95% CI 0.78-0.99; P=0.03) and all-cause mortality compared to LMWH in adults with cancer-associated VTE.

synapsesocial.com/papers/6a2bd11d6550ea4541ffe88fhttps://doi.org/10.1177/10760296261459711
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Rivaroxaban Versus Low-Molecular-Weight Heparins in a Broad Cohort of Patients With Cancer-Associated Venous Thromboembolism: An Analysis of the OSCAR-US Program2023 · 3 citations
  2. 2Rivaroxaban versus low molecular weight heparin in cancer-associated thrombosis: Assessment of clinical equipoise and bleeding risk from randomized evidence.2026
  3. 3Efficacy and safety of rivaroxaban compared with LMWH in patients with cancer-associated thrombosis: A systematic review and meta-analysis of randomized controlled trials.2026
  4. 4Rivaroxaban versus dalteparin for the treatment of cancer-associated venous thromboembolism: a systematic review and meta-analysis2025
  5. 5Effectiveness and Safety of Rivaroxaban and Low Molecular Weight Heparin in Cancer-Associated Venous Thromboembolism2023 · 21 citations