Rivaroxaban Cuts Recurrent Blood Clots in Obese Patients

Patients on rivaroxaban also have lower health care resource utilization than those on warfarin


MONDAY, Sept. 30, 2019 (HealthDay News) -- Real-world evidence shows that rivaroxaban reduces the risk for recurrent venous thromboembolism (VTE) in morbidly obese patients, with similar safety and efficacy as warfarin, according to a study published in the October issue of Thrombosis Research.

Alex C. Spyropoulos, M.D., from Northwell Health System in New York City, and colleagues used two U.S. claims databases to identify VTE patients initiating rivaroxaban or warfarin who had diagnosis codes for morbid obesity 12 months before or three months after initiation. The study included 2,890 matched pairs. Clinical and health/economic outcomes were compared for rivaroxaban versus warfarin in patients with at least three months of follow-up data.

The researchers found that risks for recurrent VTE (intent-to-treat [ITT]: odds ratio [OR], 0.99; 95 percent confidence interval [CI], 0.85 to 1.14) and major bleeding (on-treatment: OR, 0.75; 95 percent CI, 0.47 to 1.19) were similar for cohorts. In the rivaroxaban group, antifactor Xa laboratory measurements were performed on <1 percent of patients. In the rivaroxaban group, hospitalizations (OR, 0.86; 95 percent CI, 0.77 to 0.96) and outpatient visits (OR, 0.23; 95 percent CI, 0.10 to 0.56) were lower compared with the warfarin group in the ITT analysis. Average total medical costs were $2,829 per patient per year lower with rivaroxaban versus warfarin ($34,824 versus $37,653), with the difference mainly driven by hospitalization costs. Total health care costs (including pharmacy) were similar between the groups ($43,034 versus $44,565).

"Physicians should feel confident in prescribing rivaroxaban for managing VTE in this population," Spyropoulos said in a statement.

Several authors disclosed financial ties to Janssen Scientific, which manufactures rivaroxaban and funded the study.

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Published on September 30, 2019

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