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

IF 3.5 3区 医学 Q2 GERIATRICS & GERONTOLOGY
Clinical Interventions in Aging Pub Date : 2024-06-18 eCollection Date: 2024-01-01 DOI:10.2147/CIA.S405075
Chun Wang, Xiaohong Fan, Li Nie, Qing Wang, Shanshan Li, Wen Zheng, Wei Zhang, Wangshu Dai, Minmin Chen
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引用次数: 0

Abstract

Background: Rivaroxaban, a non-vitamin K antagonist oral anticoagulant, has become widely used for the management of venous thromboembolism (VTE) in adult patients. However, few trials have explored the efficacy and safety of rivaroxaban in VTE patients over 80 years of age. This necessitates further real-world studies of rivaroxaban across elderly populations.

Methods: We performed a retrospective single center study involving extremely aged VTE sufferers treated with rivaroxaban. The sample comprised 121 patients newly initiated on rivaroxaban diagnosed between January 2018 and January 2020. Patients were followed up for no less than 2 years. The effectiveness outcome was the disappearance of thromboembolism. The safety outcome was the incidence of major bleeding events. Comorbidities and complications were recorded throughout the entire study.

Results: The efficacy outcome occurred in 114 of 121 patients (94.21%) and the safety outcome occurred in 12 of 121 patients (9.91%). Increased hemorrhages were observed in patients with infection (15.15% vs 7.80%), but no significant difference was observed due to limited sample size (P=0.3053). Patients with an age-adjusted Charlson comorbidity index score higher than 6 points exhibited higher bleeding rates (14.08% vs 4.00%; P=0.0676) and lower thrombus cure rates (88.73% vs 100%; P=0.0203).

Key conclusions: Patients with infection should be more careful of bleeding events during rivaroxaban therapy. An age-adjusted Charlson comorbidity index score higher than 6, which predicted poor survival, indicated inferior safety and efficacy of rivaroxaban.

Aim: To investigate the efficacy and safety of Rivaroxaban in an aged venous thromboembolism patient population under real-world conditions.

利伐沙班对高龄静脉血栓栓塞症患者的疗效和安全性:一项回顾性、横断面真实世界研究。
背景:利伐沙班是一种非维生素 K 拮抗剂口服抗凝药,已被广泛用于治疗成年患者的静脉血栓栓塞(VTE)。然而,很少有试验探讨利伐沙班对 80 岁以上 VTE 患者的疗效和安全性。因此,有必要在老年人群中进一步开展利伐沙班的真实世界研究:我们进行了一项回顾性单中心研究,涉及接受利伐沙班治疗的高龄 VTE 患者。样本包括在 2018 年 1 月至 2020 年 1 月期间确诊的 121 名新开始使用利伐沙班的患者。对患者进行了不少于 2 年的随访。有效性结果是血栓栓塞消失。安全性结果为大出血事件的发生率。合并症和并发症在整个研究过程中均有记录:121例患者中有114例(94.21%)达到了疗效,121例患者中有12例(9.91%)达到了安全性。感染患者的出血量增加(15.15% 对 7.80%),但由于样本量有限,未观察到显著差异(P=0.3053)。经年龄调整后,Charlson合并症指数评分高于6分的患者出血率较高(14.08% vs 4.00%;P=0.0676),血栓治愈率较低(88.73% vs 100%;P=0.0203):主要结论:感染患者在利伐沙班治疗期间应更加小心出血事件。经年龄调整的Charlson合并症指数高于6分,预示生存率较低,表明利伐沙班的安全性和有效性较差。
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来源期刊
Clinical Interventions in Aging
Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-
CiteScore
6.80
自引率
2.80%
发文量
193
审稿时长
6-12 weeks
期刊介绍: Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.
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