Current Use of Rivaroxaban in Elderly Patients with Venous Thromboembolism (VTE)

Overview

Journal J Thromb Thrombolysis

Specialty Cardiology & Vascular Diseases

Date 2021 Mar 6

PMID 33674983

Citations 4

Authors

Xin Zhang

Qiyan Cai

Xiaohui Wang

Ke Liao

Changchun Hu

Hong Chen

Affiliations

Soon will be listed here.

Abstract

Venous thromboembolism (VTE), which is characterized by pulmonary embolism and deep vein thrombosis, has become a serious public concern. Notably, over half of the patients with VTE are over 70 years of age, but elderly patients are at high risk of anti-coagulation and bleeding, which increase with age. Moreover, risk factors and frailty also show a difference between elderly patients and ordinary patients diagnosed with VTE. Rivaroxaban is a direct inhibitor of activated factor Xa and has the advantage of predictable pharmacodynamics and pharmacokinetics, no coagulation monitoring, and few drug interactions. As a first-line therapy for VTE, this drug is more advantageous than traditional therapy and exhibits good efficacy and safety for ordinary patients. However, the effectiveness and safety of rivaroxaban in elderly patients have not been fully elucidated. This article reviewed the use of rivaroxaban in elderly patients, including drug interactions, monitoring, reversal agents of rivaroxaban, and the use of small dosages of rivaroxaban in elderly patients.

Citing Articles

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Efficacy and Safety of Rivaroxaban for Extremely Aged Patients with Venous Thromboembolism: A Retrospective, Cross-Sectional Real-World Study.

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Efficacy and Safety of Different Doses of Rivaroxaban and Risk Factors for Bleeding in Elderly Patients with Venous Thromboembolism: A Real-World, Multicenter, Observational, Cohort Study.

Lu K, Liao Q, Zhu K, Yao Y, Cui X, Chen P Adv Ther. 2023; 41(1):391-412.

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References

Sharma M, Cornelius V, Patel J, Davies J, Molokhia M . Efficacy and Harms of Direct Oral Anticoagulants in the Elderly for Stroke Prevention in Atrial Fibrillation and Secondary Prevention of Venous Thromboembolism: Systematic Review and Meta-Analysis. Circulation. 2015; 132(3):194-204. PMC: 4765082. DOI: 10.1161/CIRCULATIONAHA.114.013267. View

Karamichalakis N, Georgopoulos S, Vlachos K, Liatakis I, Efremidis M, Sideris A . Efficacy and safety of novel anticoagulants in the elderly. J Geriatr Cardiol. 2016; 13(8):718-723. PMC: 5067434. DOI: 10.11909/j.issn.1671-5411.2016.08.011. View

Spencer F, Gore J, Lessard D, Emery C, Pacifico L, Reed G . Venous thromboembolism in the elderly. A community-based perspective. Thromb Haemost. 2008; 100(5):780-8. PMC: 2658648. View

Pirmohamed M . Warfarin: almost 60 years old and still causing problems. Br J Clin Pharmacol. 2006; 62(5):509-11. PMC: 1885167. DOI: 10.1111/j.1365-2125.2006.02806.x. View

Scaglione F . New oral anticoagulants: comparative pharmacology with vitamin K antagonists. Clin Pharmacokinet. 2013; 52(2):69-82. DOI: 10.1007/s40262-012-0030-9. View

Prandoni P, Lensing A, Buller H, Carta M, Cogo A, Vigo M . Comparison of subcutaneous low-molecular-weight heparin with intravenous standard heparin in proximal deep-vein thrombosis. Lancet. 1992; 339(8791):441-5. DOI: 10.1016/0140-6736(92)91054-c. View

Fullerton J, Thompson J . Recertification in nurse-midwifery. A critical analysis of use of a written examination. J Nurse Midwifery. 1985; 30(2):71-8. DOI: 10.1016/0091-2182(85)90113-2. View

Douxfils J, Mullier F, Loosen C, Chatelain C, Chatelain B, Dogne J . Assessment of the impact of rivaroxaban on coagulation assays: laboratory recommendations for the monitoring of rivaroxaban and review of the literature. Thromb Res. 2012; 130(6):956-66. DOI: 10.1016/j.thromres.2012.09.004. View

Favaloro E, Bonar R, Butler J, Marsden K . Laboratory testing for the new oral anticoagulants: a review of current practice. Pathology. 2013; 45(4):435-7. DOI: 10.1097/PAT.0b013e328360f02d. View

10.

Di Minno A, Spadarella G, Prisco D, Franchini M, Lupoli R, Di Minno M . Clinical judgment when using coagulation tests during direct oral anticoagulant treatment: a concise review. Semin Thromb Hemost. 2013; 39(7):840-6. DOI: 10.1055/s-0033-1354423. View

11.

DeWald T, Becker R . The pharmacology of novel oral anticoagulants. J Thromb Thrombolysis. 2013; 37(2):217-33. DOI: 10.1007/s11239-013-0967-z. View

12.

Konstantinides S, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galie N . 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J. 2014; 35(43):3033-69, 3069a-3069k. DOI: 10.1093/eurheartj/ehu283. View

13.

Weill-Engerer S, Meaume S, Lahlou A, Piette F, Saint-Jean O, Sachet A . Risk factors for deep vein thrombosis in inpatients aged 65 and older: a case-control multicenter study. J Am Geriatr Soc. 2004; 52(8):1299-304. DOI: 10.1111/j.1532-5415.2004.52359.x. View

14.

Gaber T . Significant reduction of the risk of venous thromboembolism in all long-term immobile patients a few months after the onset of immobility. Med Hypotheses. 2005; 64(6):1173-6. DOI: 10.1016/j.mehy.2004.11.035. View

15.

Heit J, Silverstein M, Mohr D, Petterson T, OFallon W, Melton 3rd L . Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Arch Intern Med. 2000; 160(6):809-15. DOI: 10.1001/archinte.160.6.809. View

16.

Blom J, Doggen C, Osanto S, Rosendaal F . Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA. 2005; 293(6):715-22. DOI: 10.1001/jama.293.6.715. View

17.

Howell M, Geraci J, Knowlton A . Congestive heart failure and outpatient risk of venous thromboembolism: a retrospective, case-control study. J Clin Epidemiol. 2001; 54(8):810-6. DOI: 10.1016/s0895-4356(00)00373-5. View

18.

Yang C, Kao C . Cardiovascular diseases and the risk of venous thromboembolism: a hospital-based case-control study. J Chin Med Assoc. 2007; 70(3):103-9. DOI: 10.1016/S1726-4901(09)70339-9. View

19.

Sellier E, Labarere J, Sevestre M, Belmin J, Thiel H, Couturier P . Risk factors for deep vein thrombosis in older patients: a multicenter study with systematic compression ultrasonography in postacute care facilities in France. J Am Geriatr Soc. 2007; 56(2):224-30. DOI: 10.1111/j.1532-5415.2007.01545.x. View

20.

Kamphuisen P, Agnelli G, Sebastianelli M . Prevention of venous thromboembolism after acute ischemic stroke. J Thromb Haemost. 2005; 3(6):1187-94. DOI: 10.1111/j.1538-7836.2005.01443.x. View