Rivaroxaban for Thromboprophylaxis after Hospitalization for Medical Illness

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Spyropoulos, AC (Author) Other; Ageno, W (Author) Other; Albers, GW (Author) Other; Elliott, CG (Author) Other; Halperin, JL (Author) Other; Hiatt, WR (Author) Other; Maynard, GA (Author) Other; Steg, PG (Author) Other; Weitz, JI (Author) Other; Suh, E (Author) Other; Spiro, TE (Author) Other; Barnathan, ES (Author) Other; Raskob, GE (Author) Other; Jure, H (Author) Other; Alvarisqueta, A (Author) Other; Cartasegna, L (Author) Other; Hominal, M (Author) Other; Cursack, G (Author) Other; Alzogaray, M (Author) Other; Maillo, M (Author) Other; Parody, M (Author) Other; Caccavo, A (Author) Other; Dran, RD (Author) Other; Muntaner, JA (Author) Other; Casas, M (Author) Other; Schmidberg, J (Author) Other; Sarjanovich, R (Author) Other; Gabito, A (Author) Other; Garrido, M (Author) Other; Amuchastegui, M (Author) Other; Fernandez, A (Author) Other; Loureyro, J (Author) Other; Giumelli, C (Author) Other; Heazlewood, V (Author) Other; Karrasch, J (Author) Other; Colquhoun, D (Author) Other; White, H (Author) Other; Sabet, A (Author) Other; Bowler, S (Author) Other; Carroll, P (Author) Other; Khalafallah, A (Author) Other; Baker, R (Author) Other; Hedger, S (Author) Other; Simpson, FG (Author) Other; Jackson, D (Author) Other; Chong, B (Author) Other; Eichinger Hasenauer, S (Author) Other; Siostrzonek, P (Author) Other; Gary, T (Author) Other; Hoppe, U (Author) Other; Dosta, N (Author) Other; Krivenchuk, V (Author) Other; Prystrom, A (Author) Other; Gorokhovsky, S (Author) Other; Yanushko, V (Author) Other; Skrahin, A (Author) Other; Kulik, A (Author) Other; Maslianski, B (Author) Other; Yakubtsevich, R (Author) Other; Timkin, I (Author) Other; Moguchaya, O (Author) Other; Tanaskovic, N (Author) Other; Miljkovic, S (Author) Other; Stojkovic, S (Author) Other; Kovacevic Preradovic, T (Author) Other; Jovic, D (Author) Other; Basagic, E (Author) Other; Radjen, M (Author) Other; Mutapcic, M (Author) Other; Rizvanovic Vojic, E (Author) Other; Galic, K (Author) Other; Terzic, I (Author) Other; Pojskic, B (Author) Other; Stevanovic, D (Author) Other; Cehajic, M (Author) Other; Trbojevic, S (Author) Other; Rech, R (Author) Other; Annichino Bizzacchi, J (Author) Other; Stelmach, R (Author) Other; Blanco, D (Author) Other; Castro, I (Author) Other; Backes, LM (Author) Other; Saraiva, JF (Author) Other; Ramacciotti, E (Author) Other; de Barros e Silva, PGM (Author) Other; Reis, G (Author) Other; Vieira, EM (Author) Other; Leaes, P (Author) Other; Zimmermann, S (Author) Other; Van Bellen, B (Author) Other; Precoma, D (Author) Other; Silvestrini, TL (Author) Other; Hernandes, ME (Author) Other; Kyoleyan, M (Author) Other; Kalinova, T (Author) Other; Tiholov, R (Author) Other; Petrov, I (Author) Other; Mihov, A (Author) Other; Chompalova, B (Author) Other; Velikov, C (Author) Other; Pencheva, G (Author) Other; Atanasov, P (Author) Other; Raev, D (Author) Other; Kinova, E (Author) Other; Peltegov, V (Author) Other; Marchev, S (Author) Other; Mincheva, V (Author) Other; Siulemezova, S (Author) Other; Ayryanova, ID (Author) Other; Grigorov, M (Author) Other; Naydenova, I (Author) Other; Koteva, N (Author) Other; Dimov, B (Author) Other; Runev, N (Author) Other; Getov, D (Author) Other; Metev, H (Author) Other; Donchev, K (Author) Other; Taseva, M (Author) Other; Hadzhieva, A (Author) Other; Benov, H (Author) Other; Stoyanov, M (Author) Other; Tisheva Gospodinova, S (Author) Other; Mihaylova, N (Author) Other; Abadzhiev, S (Author) Other; Atzev, B (Author) Other; Georgiev, R (Author) Other; Mollov, M (Author) Other; Stoikov, A (Author) Other; Mazhdrakov, G (Author) Other; Karastanev, K (Author) Other; Dube, F (Author) Other; Roth, S (Author) Other; Mansour, S (Author) Other; Carrier, M (Author) Other; Wu, C (Author) Other; Dolan, S (Author) Other; Pesant, Y (Author) Other; Pietrangelo, M (Author) Other; Dresser, G (Author) Other; Kahn, S (Author) Other; Kruisselbrink, R (Author) Other; Bonfanti, AC (Author) Other; Botero, R (Author) Other; Ossa, AQ (Author) Other; Poveda, CM (Author) Other; Cedano, J (Author) Other; Isaza, LG (Author) Other; Torres, CV (Author) Other; Mesa, JG (Author) Other; Alonso, RV (Author) Other; Espinosa, D (Author) Other; Rodriguez, JM (Author) Other; Sanchez, G (Author) Other; Mendoza, JLA (Author) Other; Florez, CCG (Author) Other; Millan, FC (Author) Other; Pesek, K (Author) Other; Horvat, D (Author) Other; Fuckar, K (Author) Other; Tudoric, N (Author) Other; Ruzic, A (Author) Other; Ostricki, B (Author) Other; Knezevic, A (Author) Other; Breitenfeld, T (Author) Other; Laganovic, M (Author) Other; Samodol, A (Author) Other; Sikic, J (Author) Other; Starcevic, B (Author) Other; Babic, Z (Author) Other; Samarzija, M (Author) Other; Milas, K (Author) Other; Votocek, S (Author) Other; Kvapil, M (Author) Other; Spinar, J (Author) Other; Kolman, P (Author) Other; Bindas, P (Author) Other; Simon, V (Author) Other; Adamek, T (Author) Other; Svobodova, J (Author) Other; Gergely, L (Author) Other; Lastuvka, J (Author) Other; Macel, I (Author) Other; Navratil, K (Author) Other; Gregor, P (Author) Other; Lacnak, B (Author) Other; Janousek, J (Author) Other; Kellnerova, I (Author) Other; Hulinsky, V (Author) Other; Matusek, Z (Author) Other; Prucek, L (Author) Other; Dunaj, M (Author) Other; Pirchala, M (Author) Other; Vencour, D (Author) Other; Pavolko, M (Author) Other; Gorican, K (Author) Other; Fiksa, J (Author) Other; Tuxen, C (Author) Other; Meyer, C (Author) Other; Ulrik, CS (Author) Other; Marandi, T (Author) Other; Uuetoa, T (Author) Other; Shaburishvili, T (Author) Other; Otarishvili, N (Author) Other; Khintibidze, I (Author) Other; Emukhvari, N (Author) Other; Kipiani, Z (Author) Other; Gochitashvili, D (Author) Other; Mamatsashvili, M (Author) Other; Megreladze, I (Author) Other; Paposhvili, K (Author) Other; Agladze, R (Author) Other; Eradze, Z (Author) Other; Chelidze, K (Author) Other; Lominadze, S (Author) Other; Chukhrukidze, A (Author) Other; Chumburidze, V (Author) Other; Metreveli, S (Author) Other; Danelia, V (Author) Other; Orjonikidze, S (Author) Other; Kobulia, B (Author) Other; Nikolaishvili, G (Author) Other; Gvenetadze, R (Author) Other; Melia, A (Author) Other; Tsinamdzgvrishvili, B (Author) Other; Sekhniashvili, M (Author) Other; Sikharulidze, I (Author) Other; Meuser, M (Author) Other; Licka, M (Author) Other; Beyer Westendorf, J (Author) Other; Rauch Kroehnert, U (Author) Other; Graf, K (Author) Other; Brachmann, J (Author) Other; Akin, I (Author) Other; Toumbis, M (Author) Other; Vassilikos, V (Author) Other; Konstantinides, S (Author) Other; Steiropoulos, P (Author) Other; Gogos, C (Author) Other; Andrikopoulos, G (Author) Other; Parthenakis, F (Author) Other; Karydi, P (Author) Other; Tsivgoulis, G (Author) Other; Mertzanos, G (Author) Other; Olympios, C (Author) Other; Karapanayiotides, T (Author) Other; Paraskevopoulou, E (Author) Other; Kifnidis, K (Author) Other; Hahalis, G (Author) Other; Skoutelis, A (Author) Other; Vadikolias, K (Author) Other; Nyirati, G (Author) Other; Nagy, L (Author) Other; Matoltsy, A (Author) Other; Komoly, S (Author) Other; 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Bakrachevski, N (Author) Other; Kuzmanovska, B (Author) Other; Angusheva, T (Author) Other; Esperon, GL (Author) Other; Lopez, HV (Author) Other; Pech, CM (Author) Other; Hernandez, MC (Author) Other; Carrillo, LV (Author) Other; Gans, S (Author) Other; Smulders, S (Author) Other; Swart, H (Author) Other; Middeldorp, S (Author) Other; Boersma, W (Author) Other; Goosens, M (Author) Other; Hovens, M (Author) Other; Semplonius, G (Author) Other; Sohne, M (Author) Other; Osores, JL (Author) Other; Perez, MDS (Author) Other; Rodriguez, A (Author) Other; Oliva, CR (Author) Other; Cotrina, R (Author) Other; Argandona, PB (Author) Other; Yanez, LT (Author) Other; Ayala, CC (Author) Other; Mirek Bryniarska, E (Author) Other; Goch, A (Author) Other; Skucha, W (Author) Other; Skorski, M (Author) Other; Miekus, P (Author) Other; Szyszka, A (Author) Other; Piotrowski, G (Author) Other; Gniot, J (Author) Other; Czerski, T (Author) Other; Debich, P (Author) Other; Zaluska, R (Author) Other; Bebenek, W (Author) Other; Wozakowska Kaplon, B (Author) Other; Sciborski, R (Author) Other; Ilkowski, J (Author) Other; Wojnowski, P (Author) Other; Uscinska, E (Author) Other; Gaciong, Z (Author) Other; Bonek, R (Author) Other; Sobkowicz, B (Author) Other; Berkowski, P (Author) Other; Bejgier, K (Author) Other; Polonski, L (Author) Other; Kosior, D (Author) Other; Lata, S (Author) Other; Kolodziej, P (Author) Other; Gessek, J (Author) Other; Kachel, T (Author) Other; Talalaj, M (Author) Other; Musial, J (Author) Other; Lewczuk, J (Author) Other; Krysiak, W (Author) Other; Kucharski, L (Author) Other; Wysokinski, A (Author) Other; Minc, P (Author) Other; Martinez, J (Author) Other; Gregorio, T (Author) Other; Almeida, F (Author) Other; Monteiro, P (Author) Other; Stanciulescu, G (Author) Other; Mercea, CD (Author) Other; Iosipescu, LC (Author) Other; Militaru, C (Author) Other; Ciobotaru, V (Author) Other; Crisu, D (Author) Other; Burca, M (Author) Other; Tudoran, M (Author) Other; Savu, A (Author) Other; Negrean, V (Author) Other; 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Ivanov, I (Author) Other; Babic, R (Author) Other; Van Zyl, L (Author) Other; Hobson, B (Author) Other; Basson, M (Author) Other; Engelbrecht, J (Author) Other; Mitha, I (Author) Other; Siebert, H (Author) Other; Jacobson, B (Author) Other; Breedt, J (Author) Other; Prozesky, H (Author) Other; Ntsekhe, M (Author) Other; Bayat, J (Author) Other; Ellis, G (Author) Other; Tarr, G (Author) Other; Adler, D (Author) Other; Van Dyk, C (Author) Other; Ismail, SM (Author) Other; Spargo, CE (Author) Other; Abdool Gaffar, M (Author) Other; Saaiman, J (Author) Other; Venter, K (Author) Other; Aroca, MLL (Author) Other; Portales, FF (Author) Other; Navas, JP (Author) Other; Botaro, AR (Author) Other; Siminiani, ASC (Author) Other; Reyes, RL (Author) Other; Company, JBI (Author) Other; Selfa, MP (Author) Other; Garrido, JV (Author) Other; Sobrino Martinez, J (Author) Other; Delgado, GM (Author) Other; Llinas, ES (Author) Other; Coronado, JB (Author) Other; Bonet, LA (Author) Other; Gutierrez, MV (Author) Other; 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Journal

Title: New England Journal of Medicine

Vol. 379

Pages: 1118-1127

ISSN: 0028-4793

Publisher: Massachusetts Medical Society

Indexing

ISI Web of Knowledge - 81 Citations

Other information

Authenticus ID: P-00T-84X

DOI: 10.1056/nejmoa1805090

Abstract (EN): BACKGROUND Patients who are hospitalized for medical illness remain at risk for venous thromboembolism after discharge, but the role of extended thromboprophylaxis in the treatment of such patients is a subject of controversy. METHODS In this randomized, double-blind trial, medically ill patients who were at increased risk for venous thromboembolism on the basis of a modified International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) score of 4 or higher (scores range from 0 to 10, with higher scores indicating a higher risk of venous thromboembolism) or a score of 2 or 3 plus a plasma n-dimer level of more than twice the upper limit of the normal range (defined according to local laboratory criteria) were assigned at hospital discharge to either once-daily rivaroxaban at a dose of 10 mg (with the dose adjusted for renal insufficiency) or placebo for 45 days. The primary efficacy outcome was a composite of symptomatic venous thromboembolism or death due to venous thromboembolism. The principal safety outcome was major bleeding. RESULTS Of the 12,024 patients who underwent randomization, 12,019 were included in the intention-to-treat analysis. The primary efficacy outcome occurred in 50 of 6007 patients (0.83%) who were given rivaroxaban and in 66 of 6012 patients (1.10%) who were given placebo (hazard ratio, 0.76; 95% confidence interval [CI], 0.52 to 1.09; P=0.14). The prespecified secondary outcome of symptomatic nonfatal venous thromboembolism occurred in 0.18% of patients in the rivaroxaban group and 0.42% of patients in the placebo group (hazard ratio, 0.44; 95% CI, 0.22 to 0.89). Major bleeding occurred in 17 of 5982 patients (0.28%) in the rivaroxaban group and in 9 of 5980 patients (0.15%) in the placebo group (hazard ratio, 1.88; 95% CI, 0.84 to 4.23). CONCLUSIONS Rivaroxaban, given to medical patients for 45 days after hospital discharge, was not associated with a significantly lower risk of symptomatic venous thromboembolism and death due to venous thromboembolism than placebo. The incidence of major bleeding was low.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10