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To compare the efficacy and safety of rivaroxaban (20 mg/day) with low molecular weight (LMW) and Vit K antagonists in the treatment of PICC associated UEDVT.
84 patients with PICC associated UEDVT were studied. All had UEDVT identified by ultrasound. Further ultrasound images were obtained at 1, 2 and 3 months after the start of treatment. 44 patients were treated with rivaroxaban and 40 with initial LMH heparin and Vit K antagonist with continuation of Vit K antagonists alone once INR was therapeutic.
In the rivaroxaban group mean age was 51±16y and 57% were male, whilst in the other group respective values were 50±16 and 56%. All patients were receiving treatment for cancer. Resolution of thrombus had occurred in 53.5% at 1 month, 76.1% at 2 months and 92.6% at 3 months in the rivaroxaban treated subjects. Corresponding values in the LMW heparin/Vit antagonist treated patients were 34.2%, 55.5% and 88.5% respectively. Differences between groups were significant at 1 (p<0.01) and 2 months (p<0.05). There were no major bleeds in either group and cumulative bleeding rates by 3 months were 7.3 % in the rivaroxaban and 11.4% in the LMW heparin/Vit K antagonist groups.
Rivaroxaban led to faster resolution of PICC associated UEDVT than LMW/Vit K antagonists without any increase in bleeding.