Treatment of Acute Lower Extremity Deep Venous Thrombosis with Rivaroxiban versus Warfarin

Objectives: to assess extent of thrombus resolution and rate of complications in patients with lower extremity acute Deep Venous Thrombosis (DVT) treated with rivaroxaban compared to warfarin therapy. Background: For years, the standard treatment for acute lower extremity DVT has been the use of warfarin with bridge therapy by enoxaparin. New oral anticoagulant drugs such as rivaroxaban have been developed and used as an alternative to warfarin in the treatment of acute lower extremity DVT. Methods: This is a prospective study that was conducted on 130 patients to assess extent of thrombus resolution and rate of complications in patients with lower extremity acute DVT treated with rivaroxaban (15 mg twice daily for 21 days, followed by 20 mg once daily) compared to warfarin therapy. Patients were followed up after three and six months of onset of treatment and the progression of the thrombus was noted using doppler ultrasound together with any symptoms or signs of bleeding, recurrence of symptoms or pulmonary embolism. Results: We divided the 130 patients into two equal groups and compared the obtained results from each group. There was no statistically significant difference between the two groups regarding the resolution of the thrombus or the rate of complications. However, we found that patients treated with rivaroxaban had found relief of their symptoms earlier than those treated with warfarin. Conclusion: No statistically significant difference between rivaroxaban and warfarin regarding their safety and efficacy with faster relief of symptoms when using rivaroxaban.