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Final ID: MDP139

Efficacy and Safety of Rivaroxaban Versus Low Molecular Weight Heparin for Treating Venous Thromboembolism in Cancer Patients: A Systematic Review and Meta-Analysis

Abstract Body (Do not enter title and authors here): Background: Rivaroxaban is a novel oral anticoagulant suggested as an alternative to low molecular weight heparin (LMWH). However, its efficacy and safety compared to LMWH for treating venous thromboembolism (VTE) in cancer patients remain unclear.

Hypothesis: This study aims to compare the efficacy and safety of rivaroxaban against LMWH for treating VTE in cancer patients.

Methods: We conducted a literature search for relevant articles on PubMed, Google Scholar, and Embase. Outcomes were pooled using the DerSimonian and Laird random-effects model as risk ratios (RR) with 95% confidence intervals (CI). A p-value of <0.05 was considered statistically significant.

Results: A total of 14368 cancer patients (Rivaroxaban: 4378 and LMWH: 9990) from 13 studies were included with an average age of 62.5 and 61.9 respectively.
At 3 months, rivaroxaban was associated with a decreased risk of recurrent VTE (RR 0.73, 95% CI: 0.59, 0.86, p<0.05) and bleeding-related hospitalization (RR 0.79, 95% CI: 0.61, 0.97, p<0.05) with statistical signifcant whereas, major bleeding (RR 0.87, 95% CI: 0.09, 1.65), non-major bleeding (RR 0.84, 95% CI: 0.60, 1.08) and all-cause mortality (RR 0.91, 95% CI: 0.72, 1.09) were comparable.
At 6 months, rivaroxaban was associated with a decreased risk of all-cause mortality (RR 0.80, 95% CI: 0.62, 0.97, p<0.05), and bleeding-related hospitalization (RR 0.81, 95% CI: 0.65, 0.98, p<0.05) whereas major bleeding (RR 0.88, 95% CI: 0.52, 1.24), non-major bleeding (RR 0.85, 95% CI: 0.42, 1.29) and recurrent VTE (RR 0.83, 95% CI: 0.64, 1.01) were comparable.
At 12 months, rivaroxaban was associated with a decreased risk of mortality (RR 0.71, 95% CI: 0.50, 0.92, p<0.05), however non-major bleeding (RR 1.38, 95% CI: 0.83, 1.94), cancer-associated thrombosis recurrence (RR 0.94, 95% CI: 0.73, 1.16), and bleeding (RR 0.70, 95% CI: 0.26, 1.15) were comparable.

Conclusion: While rivaroxaban is associated with low adverse outcomes suggesting its use in treating VTE in cancer patients, further research is recommended.
  • Shrestha, Abhigan  ( Medical Research Hub, Nepal , Kathmandu , Nepal )
  • Mainali, Nischal  ( Kathmandu Medial College and Teaching Hospital , Kathmandu , Nepal )
  • Shrestha, Sajina  ( Kist medical college and teaching hospital , Lalitpur , Nepal )
  • Jaiswal, Vikash  ( JCCR Cardiology Research , Jaunpur , India )
  • Rajak, Kripa  ( UPMC , Harrisburg , Pennsylvania , United States )
  • Hameed, Maha  ( Florida State University , Sarasota , Florida , United States )
  • Edara, Ravi Sankar Reddy  ( Virginia Commonwealth University School of Medicine , Virginia , Virginia , United States )
  • Kc, Anil  ( Mayo Clinic , Jacksonville , Florida , United States )
  • Author Disclosures:
    Abhigan Shrestha: DO NOT have relevant financial relationships | Nischal Mainali: DO NOT have relevant financial relationships | Sajina Shrestha: No Answer | Vikash Jaiswal: DO NOT have relevant financial relationships | Kripa Rajak: DO NOT have relevant financial relationships | Maha Hameed: DO NOT have relevant financial relationships | Ravi Sankar Reddy Edara: DO NOT have relevant financial relationships | ANIL KC: DO NOT have relevant financial relationships
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

Venous Thromboembolism: Approaching Never Events?

Saturday, 11/16/2024 , 11:10AM - 12:35PM

Moderated Digital Poster Session

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