Patients treated with Xarelto (rivaroxaban; Janssen) for deep vein thrombosis (DVT) had less frequent hospital admissions than those treated with standard low molecular weight heparin (LMWH) and warfarin, according to study data presented at the Hospital Medicine 2015 Congress.
Xarelto is a factor Xa inhibitor currently indicated to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation; as treatment of deep vein thrombosis (DVT), pulmonary embolism (PE); to reduce the risk of recurrence of DVT, PE following six months treatment for DVT, PE; as prophylaxis of DVT, which may lead to PE in patients undergoing knee or hip replacement surgery.
In the observational study, 134 patients were treated with Xarelto and 536 patients were treated with LMWH and warfarin according to the Truven MarketScan Hospital Drug Database. Study results were as follows:
- A 27% reduction in hospital admissions when patients were treated with Xarelto instead of LMWH and warfarin (P<0.001). Of those given Xarelto, 60% were admitted to the hospital, while 40% were discharged within 24 hours. Of the LMWH/warfarin group, 82% were admitted to the hospital, with 18% discharged within 24 hours.
- Similar rates of subsequent hospital visits were observed during the first six months between the two groups, with a trend toward fewer hospital visits in the Xarelto group vs. LMWH/warfarin group (4.4% vs. 7.2%, P=0.342).
- Corresponding hospitalization costs were also significantly lower for people given Xarelto ($5,257/person) vs. those given LMWH and warfarin ($6,764/person), which resulted in a cost difference of $1,508 per person (P=0.002).
Researchers noted that the small sample size of the rivaroxaban cohort, patients largely being from the southern U.S., and being matched based on available information may limit the generalizability of the findings.
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