Why the study?
Does initial therapy with enoxaparin followed by rivaroxaban 20 mg daily safely and effectively treat acute lower limb venous thromboembolism?
Does initial therapy with enoxaparin followed by rivaroxaban 20 mg daily safely and effectively treat acute lower limb venous thromboembolism?
A retrospective pilot study suggests that treating acute lower limb VTE with a short course of enoxaparin followed directly by rivaroxaban 20 mg daily is safe and effective, offering an alternative to the standard rivaroxaban loading dose.
Supports evaluation of enoxaparin bridge to rivaroxaban 20 mg in acute VTE; hypothesis-generating and should not change practice without randomized confirmation.
Rivaroxaban is a target-specific oral anticoagulant approved for the treatment of venous thromboembolism (VTE). On its major clinical trials, treatment was initiated directly with a 3-week dose of oral 15 mg twice daily followed by 20 mg every day for at least 3 months. We retrospectively evaluated an initial therapy for confirmed VTE with 1 to 18 days of enoxaparin (1 mg/kg twice daily parenteral) followed by oral rivaroxaban 20 mg every day. Of 49 patients, we found no symptomatic recurrence, no major bleeding, and only 1 clinically relevant nonmajor bleeding. We concluded in this pilot study that it is safe and effective to treat patients with enoxaparin course followed directly by a dose of 20 mg of rivaroxaban.
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Wolosker et al. (2016) studied this question.
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