Korean J Urol Oncol.  2019 Dec;17(3):178-185. 10.22465/kjuo.2019.17.3.178.

A Study on the Efficacy and Safety of Rivaroxaban in Urologic Cancer-Associated Venous Thromboembolism

Affiliations
  • 1Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jsdoc1186@hotmail.com
  • 2Department of Urology, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Although direct oral anticoagulants (DOACs) are recommended as an alternative to low-molecular weighted heparin for cancer-associated venous thromboembolism (VTE), there is no firm evidence on the efficacy and safety of DOACs in patients with urologic cancer. Therefore, we compared the efficacy and safety of rivaroxaban and dalteparin for treating cancer-associated VTE in urologic cancer.
MATERIALS AND METHODS
We reviewed the medical records of 124 eligible VTE patients with urologic cancers who were treated with dalteparin or rivaroxaban. The primary outcome was the composite event of clinically relevant bleeding or VTE recurrence. The secondary outcomes were VTE recurrence, clinically relevant bleeding events, and all-cause mortality.
RESULTS
During anticoagulation period, there was no significant difference in primary and secondary outcomes between the groups. In Cox proportional hazards model for composite events, although there was no statistical significance, rivaroxaban presented lower hazard ratio (HR) than dalteparin (HR, 0.472; 95% confidence interval [CI], 0.210-1.060; p=0.069 in univariate analysis; HR, 0.505; 95% CI, 0.206-1.234; p=0.134 in multivariate analysis). In clinically relevant bleeding events, there was no significance difference between rivaroxaban and dalteparin (HR, 0.568; 95% CI, 0.238-1.358; p=0.203 in univariate analysis; HR, 0.617; 95% CI, 0.232-1.636; p=0.331 in multivariate analysis).
CONCLUSIONS
Rivaroxaban can be regarded as a valuable option for VTE in urologic cancer. Further prospective studies are warranted to prove the safety or efficacy of rivaroxaban for treating VTE in patients with urologic cancer.

Keyword

Anticoagulants; Dalteparin; Rivaroxaban; Urologic neoplasm; Venous thromboembolism

MeSH Terms

Anticoagulants
Dalteparin
Hemorrhage
Heparin
Humans
Medical Records
Mortality
Proportional Hazards Models
Prospective Studies
Recurrence
Rivaroxaban*
Urologic Neoplasms
Venous Thromboembolism*
Anticoagulants
Dalteparin
Heparin
Rivaroxaban
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