Comparative Study between Rivaroxaban and Warfarin inTreatment of Patients with Recurrent Deep Venous Thrombosis

Background: Venous Thrombo-Embolism (VTE) manifestsas Deep Venous Thrombosis (DVT) and/or Pulmonary Em-bolism (PE). Per 1000 persons in the general population, theannual incidence is 1 to 2 cases. For decades, the gold standard of anti-thrombotic therapy has been based on heparins and Vitamin K Antagonists (VKAs), their narrow therapeutic range and multiple interactions led to the development of New Oral Anticoagulants (NOACs) beginning in 2003. Two types of new anticoagulants have been developed: Direct factor Xa inhibitors (Rivaroxaban) and direct factor IIa (thrombin) inhibitors.Aim of Study: The aim of this study was to comparerivaroxaban versus warfarin in treatment of recurrent DVTas regard efficacy, safety and complications.Patients and Methods: This was a prospective studyconducted on 30 patients suffering from recurrent deep venousthrombosis. The studied cases were divided into two groups,Group A treated by rivaroxaban, while group B treated bywarfarin over a period of 6 months. All cases were subjectedto full history taking, complete general and local examination,routine laboratory investigations and Duplex Scanning.Results: No statistically significant differences amongrivaroxaban and warfarin groups as regards presence of riskfactors, DVT extension, duplex results and incidence ofcomplications, while there was significant difference as regardsduration till symptoms relief.Conclusion: Rivaroxaban seems to have same efficacyas warfarin with advantage being earlier in symptoms relief/days, recanalization and patient compliance. In addition,warfarin users need to be monitored regularly.