Why the study?
Ambulant patients with lower limb DVT managed with warfarin require initial rapid-acting anticoagulant bridging until a stable therapeutic INR is reached, prompting a comparison between subcutaneous LMWH and oral rivaroxaban.
Does oral rivaroxaban bridging improve short-term outcomes compared to subcutaneous LMWH bridging in ambulant patients with DVT treated with warfarin?
Cohort (n=222)
Does oral rivaroxaban bridging improve short-term outcomes compared to subcutaneous LMWH bridging in ambulant patients with DVT treated with warfarin?
Oral rivaroxaban is a suitable and non-injectable alternative to subcutaneous LMWH for bridging therapy during the initiation of warfarin in patients with DVT.
PURPOSE: In ambulant patients with lower limb DVT managed with Warfarin, there is a need for initial treatment and short time "bridging" with a rapidly acting anticoagulant until there is a stable therapeutic INR. In this study, results from bridging with subcutaneous low molecular weight heparin (LMWH) or oral Rivaroxaban were compared. METHODS: One hundred and twenty-four patients received LMWH and 98 patients received Rivaroxaban, both in addition to Warfarin. Patients were assessed at 1 and 4 weeks after treatment initiation for thrombus progression, bleeding, clinic attendance and INR. FINDINGS: The treatment groups were well matched. There were no significant differences between the treatment groups for any of the end-points at either 1 week or 4 weeks. IMPLICATIONS: In ambulant patients with DVT treated with Warfarin both Rivaroxaban and LMWH are suitable for use in the early phase of Warfarin treatment until therapeutic INR is achieved. Rivaroxaban is a suitable alternative to LMWH for patients who prefer not to have injections.
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Fan et al. (2021) conducted a cohort in Symptomatic lower limb deep vein thrombosis (DVT) (n=222). Oral Rivaroxaban vs. Subcutaneous low molecular weight heparin (LMWH) was evaluated on Thrombus progression, bleeding, clinic attendance and INR.
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