Edoxaban treatment without initial heparin lead-in for acute venous thromboembolism: insight from the COMMAND VTE registry-2

被引：0

作者：

Tsujisaka, Yuta ^{[1
]}

Yamashita, Yugo ^{[1
,32
]}

Morimoto, Takeshi ^{[2
]}

Chatani, Ryuki ^{[3
]}

Kaneda, Kazuhisa ^{[1
]}

Nishimoto, Yuji ^{[4
]}

Ikeda, Nobutaka ^{[5
]}

Kobayashi, Yohei ^{[6
]}

Ikeda, Satoshi ^{[7
]}

Kim, Kitae ^{[8
]}

Inoko, Moriaki ^{[9
]}

Takase, Toru ^{[10
]}

Tsuji, Shuhei ^{[11
]}

Oi, Maki ^{[12
]}

Takada, Takuma ^{[13
]}

Otsui, Kazunori ^{[14
]}

Sakamoto, Jiro ^{[15
]}

Ogihara, Yoshito ^{[16
]}

Inoue, Takeshi ^{[17
]}

Usami, Shunsuke ^{[18
]}

Chen, Po-Min ^{[19
]}

Togi, Kiyonori ^{[20
]}

Koitabashi, Norimichi ^{[21
]}

Hiramori, Seiichi ^{[22
]}

Doi, Kosuke ^{[23
]}

Mabuchi, Hiroshi ^{[24
]}

Tsuyuki, Yoshiaki ^{[25
]}

Murata, Koichiro ^{[26
]}

Takabayashi, Kensuke ^{[27
]}

Nakai, Hisato ^{[28
]}

Sueta, Daisuke ^{[29
]}

Shioyama, Wataru ^{[30
]}

Dohke, Tomohiro ^{[31
]}

Nishikawa, Ryusuke ^{[1
]}

Ono, Koh ^{[1
]}

Kimura, Takeshi ^{[27
]}

机构：

[1] Kyoto Univ, Grad Sch Med, Dept Cardiovasc Med, Kyoto, Japan

[2] Hyogo Coll Med, Dept Data Sci, Nishinomiya, Japan

[3] Kurashiki Cent Hosp, Dept Cardiovasc Med, Kurashiki, Japan

[4] Hyogo Prefectural Amagasaki Gen Med Ctr, Dept Cardiol, Amagasaki, Japan

[5] Toho Univ, Ohashi Med Ctr, Div Cardiovasc Med, Tokyo, Japan

[6] Osaka Red Cross Hosp, Dept Cardiovasc Ctr, Osaka, Japan

[7] Nagasaki Univ, Grad Sch Biomed Sci, Dept Cardiovasc Med, Nagasaki, Japan

[8] Kobe City Med Ctr Gen Hosp, Dept Cardiovasc Med, Kobe, Japan

[9] Kitano Hosp, Tazuke Kofukai Med Res Inst, Cardiovasc Ctr, Osaka, Japan

[10] Kinki Univ Hosp, Dept Cardiol, Osaka, Japan

[11] Japanese Red Cross Wakayama Med Ctr, Dept Cardiol, Wakayama, Japan

[12] Japanese Red Cross Otsu Hosp, Dept Cardiol, Otsu, Japan

[13] Tokyo Womens Med Univ, Dept Cardiol, Tokyo, Japan

[14] Kobe Univ Hosp, Dept Gen Internal Med, Kobe, Japan

[15] Tenri Hosp, Dept Cardiol, Tenri, Japan

[16] Mie Univ, Grad Sch Med, Dept Cardiol & Nephrol, Tsu, Japan

[17] Shiga Gen Hosp, Dept Cardiol, Moriyama, Japan

[18] Kansai Elect Power Hosp, Dept Cardiol, Osaka, Japan

[19] Osaka Saiseikai Noe Hosp, Dept Cardiol, Osaka, Japan

[20] Kinki Univ, Nara Hosp, Div Cardiol, Fac Med, Ikoma, Japan

[21] Gunma Univ, Grad Sch Med, Dept Cardiovasc Med, Maebashi, Japan

[22] Kokura Mem Hosp, Dept Cardiol, Kokura, Japan

[23] Natl Hosp Org Kyoto Med Ctr, Dept Cardiol, Kyoto, Japan

[24] Koto Mem Hosp, Dept Cardiol, Higashiomi, Japan

[25] Shimada Gen Med Ctr, Div Cardiol, Shimada, Japan

[26] Shizuoka City Shizuoka Hosp, Dept Cardiol, Shizuoka, Japan

[27] Hirakata Kohsai Hosp, Dept Cardiol, Hirakata, Japan

[28] Sugita Genpaku Mem Obama Municipal Hosp, Dept Cardiovasc Med, Obama, Japan

[29] Kumamoto Univ, Grad Sch Med Sci, Dept Cardiovasc Med, Kumamoto, Japan

[30] Shiga Univ Med Sci, Dept Cardiovasc Med, Otsu, Japan

[31] Kohka Publ Hosp, Div Cardiol, Koka, Japan

[32] Kyoto Univ, Grad Sch Med, Dept Cardiovasc Med, 54 Shogoin Kawahara Cho,Sakyo Ku, Kyoto 6068507, Japan

来源：

JOURNAL OF THROMBOSIS AND THROMBOLYSIS | 2025年 / 58卷 / 05期

关键词：

Venous thromboembolism; Edoxaban; Heparin; Lead-in; Outcome; FACTOR XA INHIBITOR; DEEP-VEIN THROMBOSIS; RIVAROXABAN; WARFARIN;

D O I：

10.1007/s11239-025-03105-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The package insert of edoxaban for acute venous thromboembolism (VTE) recommended administration following initial parenteral anticoagulation including heparin. We explored the effectiveness and safety of edoxaban for acute VTE without initial heparin lead-in treatment. The COMMAND VTE Registry-2 is a multicenter registry enrolling 5197 consecutive acute symptomatic VTE patients in Japan between January 2015 and August 2020. The current study population consisted of 1842 patients with acute VTE treated with edoxaban. The baseline characteristics and clinical outcomes were compared between the 2 groups with or without initial heparin lead-in treatment stratified by pulmonary embolism (PE) (848 patients) and deep vein thrombosis (DVT) only (994 patients). Propensity score (PS) matching analysis was performed to balance potential baseline differences. PE and DVT patients without heparin lead-in treatment accounted for 225 (27%) and 750 (75%), respectively. PS matching provided 195 pairs of PE patients and 224 pairs of DVT patients. There was no significant difference between the no heparin and heparin groups in the cumulative 30-day incidence of all-cause death (PE: 2.6% vs. 4.2%, P = 0.40; DVT: 2.7% vs. 3.2%, P = 0.78) and a composite of all-cause death, recurrent VTE, or major bleeding (PE: 5.8% vs. 8.4%, P = 0.32; DVT: 4.6% vs. 6.4%, P = 0.41). In the current real-world VTE registry, a substantial proportion of patients with acute VTE were treated with edoxaban without initial heparin lead-in treatment. There was no obvious signal suggesting worse short-term clinical outcomes with edoxaban treatment without versus with initial heparin lead-in treatment.Graphical abstractOverview chart of the current study.

引用

页码：591 / 600

页数：10

共 16 条

[1] Treatment of proximal deep-vein thrombosis with the oral direct factor Xa inhibitor rivaroxaban (BAY 59-7939) - The ODIXa-DVT (oral direct factor Xa inhibitor BAY 59-7939 in patients with acute symptomatic deep-vein thrombosis) study [J].

Agnelli, Giancarlo ;

Gallus, Alexander ;

Goldhaber, Samuel Z. ;

Haas, Sylvia ;

Huisman, Menno V. ;

Hull, Russel D. ;

Kakkar, Ajay K. ;

Misselwitz, Frank ;

Schellong, Sebastian .

CIRCULATION, 2007, 116 (02) :180-187

[2]

Brekelmans Marjolein P A, 2018, TH Open, V2, pe1, DOI 10.1055/s-0037-1615251

[3] Edoxaban versus Warfarin for the Treatment of Symptomatic Venous Thromboembolism [J].

Bueller, Harry R. ;

Decousus, Herve ;

Grosso, Michael A. ;

Mercuri, Michele ;

Middeldorp, Saskia ;

Prins, Martin H. ;

Raskob, Gary E. ;

Schellong, Sebastian M. ;

Schwocho, Lee ;

Segers, Annelise ;

Shi, Minggao ;

Verhamme, Peter ;

Wells, Phil .

NEW ENGLAND JOURNAL OF MEDICINE, 2013, 369 (15) :1406-1415

[4] Efficacy and safety of the oral direct factor Xa inhibitor apixaban for symptomatic deep vein thrombosis. The Botticelli DVT dose-ranging study [J].

Buller, H. ;

Deitchman, D. ;

Prins, M. ;

Segers, A. .

JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2008, 6 (08) :1313-1318

[5] A dose-ranging study evaluating once-daily oral administration of the factor Xa inhibitor rivaroxaban in the treatment of patients with acute symptomatic deep vein thrombosis: the Einstein-DVT Dose-Ranging Study [J].

Buller, Harry R. ;

Lensing, Anthonie W. A. ;

Prins, Martin H. ;

Agnelli, Giancarlo ;

Cohen, Alexander ;

Gallus, Alexander S. ;

Misselwitz, Frank ;

Raskob, Gary ;

Schellong, Sebastian ;

Segers, Annelise .

BLOOD, 2008, 112 (06) :2242-2247

[6]

Buller HR, 2007, NEW ENGL J MED, V357, P1094

[7] Drug-Drug Interactions of Direct Oral Anticoagulants (DOACs): From Pharmacological to Clinical Practice [J].

Ferri, Nicola ;

Colombo, Elisa ;

Tenconi, Marco ;

Baldessin, Ludovico ;

Corsini, Alberto .

PHARMACEUTICS, 2022, 14 (06)

[8]

Ho DE, 2011, J STAT SOFTW, V42

[9] Anticoagulation strategies and long-term recurrence in patients with venous thromboembolism in the era of direct oral anticoagulants [J].

Kaneda, Kazuhisa ;

Yamashita, Yugo ;

Morimoto, Takeshi ;

Chatani, Ryuki ;

Nishimoto, Yuji ;

Ikeda, Nobutaka ;

Kobayashi, Yohei ;

Ikeda, Satoshi ;

Kim, Kitae ;

Inoko, Moriaki ;

Takase, Toru ;

Tsuji, Shuhei ;

Oi, Maki ;

Takada, Takuma ;

Otsui, Kazunori ;

Kimura, Takeshi .

EUROPEAN JOURNAL OF INTERNAL MEDICINE, 2023, 118 :59-72

[10] 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS) [J].

Konstantinides, Stavros V. ;

Meyer, Guy ;

Becattini, Cecilia ;

Bueno, Hector ;

Geersing, Geert-Jan ;

Harjola, Veli-Pekka ;

Huisman, Menno V. ;

Humbert, Marc ;

Jennings, Catriona Sian ;

Jimenez, David ;

Kucher, Nils ;

Lang, Irene Marthe ;

Lankeit, Mareike ;

Lorusso, Roberto ;

Mazzolai, Lucia ;

Meneveau, Nicolas ;

Ni Ainle, Fionnuala ;

Prandoni, Paolo ;

Pruszczyk, Piotr ;

Righini, Marc ;

Torbicki, Adam ;

Van Belle, Eric ;

Luis Zamorano, Jose .

EUROPEAN RESPIRATORY JOURNAL, 2019, 54 (03)

← 1 2 →