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Rivaroxaban for the treatment of symptomatic deep-vein thrombosis and pulmonary embolism in Chinese patients: a subgroup analysis of the EINSTEIN DVT and PE studies

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机构: [1]Fudan Univ, Zhongshan Hosp, Dept Vasc Surg, Shanghai, Peoples R China; [2]Beijing Chaoyang Hosp, Beijing Inst Resp Med, Beijing, Peoples R China; [3]Beijing Anzhen Hosp, Dept Vasc Surg, Beijing, Peoples R China; [4]Shanghai Jiao Tong Univ, Renji Hosp, Sch Med, Shanghai, Peoples R China; [5]Cardiovasc Inst, Dept Cardiol, Beijing, Peoples R China; [6]Fu Wai Hosp, Beijing, Peoples R China; [7]Huazhong Univ Sci & Technol, Wuhan Union Hosp, Tongji Med Coll, Dept Surg, Wuhan, Hubei, Peoples R China; [8]Zhejiang Univ, Sir Run Run Shaw Hosp, Sch Med, Dept Resp Med, Hangzhou, Zhejiang, Peoples R China; [9]Peking Union Med Coll Hosp, Dept Gen Surg, Beijing, Peoples R China; [10]Harbin Med Univ, Affiliated Hosp 2, Dept Resp Med, Harbin, Heilongjiang, Peoples R China; [11]Tongji Univ, Affiliated Shanghai Pulm Hosp, Dept Pulm Circulat, Shanghai, Peoples R China; [12]Peking Union Med Coll, Fu Wai Hosp, Thrombosis & Vasc Med Ctr, State Key Lab Cardiovasc Dis, Beijing, Peoples R China; [13]Chinese Acad Med Sci, Beijing, Peoples R China; [14]Bayer HealthCare, Berlin, Germany; [15]Maastricht Univ, Maastricht, Netherlands; [16]Bayer HealthCare, Aprather Weg 18a, D-42096 Wuppertal, Germany
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关键词: Rivaroxaban Deep vein thrombosis Pulmonary embolism Venous thromboembolism Vitamin K antagonist Randomized trial

摘要:
Background: The worldwide EINSTEIN DVT and EINSTEIN PE studies randomized 8282 patients with acute symptomatic deep- vein thrombosis (DVT) and/or pulmonary embolism (PE) and, for the first time in trials in this setting, included patients in China. This analysis evaluates the results of these studies in this subgroup of patients. Methods: A total of 439 Chinese patients who had acute symptomatic DVT (n=211), or PE with or without DVT (n=228), were randomized to receive rivaroxaban (15 mg twice daily for 21 days, followed by 20 mg once daily) or standard therapy of enoxaparin overlapping with and followed by an adjusted-dose vitamin K antagonist, for 3, 6, or 12 months. The primary efficacy outcome was symptomatic recurrent venous thromboembolism. The principal safety outcome was major or non- major clinically relevant bleeding. Results: The primary efficacy outcome occurred in seven (3.2%) of the 220 patients in the rivaroxaban group and in seven (3.2%) of the 219 patients in the standard- therapy group (hazard ratio, 1.04; 95% confidence interval 0.36-3.0; p= 0.94). The principal safety outcome occurred in 13 (5.9%) patients in the rivaroxaban group and in 20 (9.2%) patients in the standard-therapy group (hazard ratio, 0.63; 95% confidence interval 0.31- 1.26; p= 0.19). Major bleeding was observed in no patients in the rivaroxaban group and in five (2.3%) patients in the standard- therapy group. In fragile patients (defined as age > 75 years, creatinine clearance < 50 mL/min, and/or body weight = 50 kg), the principal safety outcome occurred in four (8.9%) of the 45 patients who received rivaroxaban compared with seven (15.2%) of the 46 patients who received standard therapy. Conclusions: In Chinese patients with acute symptomatic DVT and/ or PE, rivaroxaban was as efficacious as enoxaparin followed by vitamin K antagonist therapy, with a similar safety profile. The relative efficacy and safety of rivaroxaban compared with enoxaparin/ vitamin K antagonist were consistent with that found in the rest of the world.

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大类 | 4 区 医学
小类 | 4 区 血液学 4 区 外周血管病
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第一作者机构: [1]Fudan Univ, Zhongshan Hosp, Dept Vasc Surg, Shanghai, Peoples R China;
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通讯机构: [16]Bayer HealthCare, Aprather Weg 18a, D-42096 Wuppertal, Germany
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