Key result
Rivaroxaban-treated isolated distal DVT shows similar VTE recurrence but ~66% less major bleeding than proximal DVT.
Why the study?
The effectiveness and safety of rivaroxaban in patients with isolated distal deep vein thrombosis (IDDVT) were not well established.
Does rivaroxaban safely and effectively prevent VTE recurrence in patients with isolated distal deep vein thrombosis compared to proximal DVT?
Observational (n=1,016)
Yes
Does rivaroxaban safely and effectively prevent VTE recurrence in patients with isolated distal deep vein thrombosis compared to proximal DVT?
Short-term, low-dose rivaroxaban is safe and effective for treating isolated distal deep vein thrombosis, demonstrating comparable VTE recurrence and lower major bleeding rates compared to proximal DVT treatment.
Answers are grounded in this paper and cite their sources.
Supports rivaroxaban for isolated distal DVT with similar recurrence and less bleeding; hypothesis-generating and should not yet change practice.
Objectives We assessed the effectiveness and safety of rivaroxaban in patients with isolated distal deep vein thrombosis (IDDVT). Methods Symptomatic venous thromboembolism (VTE) and major bleeding were assessed. Results Of 1016 patients with acute symptomatic/asymptomatic DVT and/or pulmonary embolism treated with rivaroxaban, 288 had IDDVT and 294 had proximal DVT (pDVT). The IDDVT group had fewer patients on the higher rivaroxaban dose (30 mg/day) (42.7% vs. 66.0%) and a shorter treatment duration (135.5 vs 369.5 days) than the pDVT group. VTE recurrence occurred in 14 and 11 patients with IDDVT and pDVT, respectively (2.89% vs. 2.29% per patient-year; p = 0.534). Major bleeding was less frequent in the IDDVT group (1.55% vs. 4.53% per patient-year; p = 0.044). Comparable effectiveness and safety were observed with 15 and 30 mg/day rivaroxaban in the IDDVT group. Conclusions Short-term, low-dose rivaroxaban seems safe and effective for IDDVT treatment.
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Mo et al. (2022) conducted an observational in Acute distal deep vein thrombosis (n=1,016). Isolated distal deep vein thrombosis (IDDVT) treated with rivaroxaban vs. Proximal DVT (pDVT) treated with rivaroxaban was evaluated on Symptomatic venous thromboembolism (VTE) recurrence (p=0.534). In patients treated with rivaroxaban, isolated distal DVT had similar VTE recurrence rates (2.89% vs. 2.29% per patient-year; p=0.534) and less major bleeding (1.55% vs. 4.53%; p=0.044) than proximal DVT.
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