Key result
Rivaroxaban resolves massive thrombi within 7 days in inherited antithrombin deficiency.
Why the study?
The efficacy of oral factor Xa inhibitors for treatment and prevention of venous thromboembolism in patients with inherited antithrombin deficiency is not well established.
Does rivaroxaban treat and prevent venous thromboembolism in a patient with antithrombin deficiency?
Case Report (n=1)
No
Does rivaroxaban treat and prevent venous thromboembolism in a patient with antithrombin deficiency?
This case report suggests that the oral factor Xa inhibitor rivaroxaban may be effective for the treatment and prevention of venous thromboembolism in patients with antithrombin deficiency.
Rivaroxaban resolved acute VTE in suspected antithrombin deficiency; leaves open its efficacy and safety versus alternatives in this population.
A 19-year-old man was referred due to sudden onset of right foot pain and chest discomfort. Contrast-enhanced computed tomography revealed massive thrombi in the right pulmonary artery and femoral vein. The patient's father had experienced multiple recurrences of venous thromboembolism (VTE) and was diagnosed with inherited antithrombin deficiency by a genetic examination. The patient was administered the oral factor Xa inhibitor rivaroxaban (30 mg). After seven days, the thrombus disappeared. Rivaroxaban (15 mg) was continued for 6 months with no recurrence, indicating the efficacy of this factor Xa inhibitor for the treatment and prevention of VTE in patients with antithrombin deficiency.
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Minami et al. (2018) conducted a case report in Venous thromboembolism with inherited antithrombin deficiency (n=1). Rivaroxaban was evaluated on Thrombus resolution and VTE recurrence. Rivaroxaban successfully resolved massive pulmonary and femoral thrombi within seven days and prevented venous thromboembolism recurrence over 10 months in a patient with inherited antithrombin deficiency.
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