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Risk of Gastrointestinal Bleeding with Rivaroxaban: A Comparative Study with Warfarin
Muhammed Sherid1, Samian Sulaiman2, Salih Samo3
1Section of Gastroenterology and Hepatology, Georgia Regents University, 1120 15th Street, AD 2226, Augusta, GA 30912, USA.
Gastroenterology Research and Practice
|February 17, 2016
Summary
Gastrointestinal bleeding risk was similar between rivaroxaban and warfarin. Early use of rivaroxaban, dual antiplatelet agents, and prior bleeding increased GI risk.
Area of Science:
- Pharmacology
- Gastroenterology
- Clinical Medicine
Background:
- Gastrointestinal (GI) bleeding risk with rivaroxaban requires further investigation.
- Comparison of GI bleeding incidence between rivaroxaban and warfarin is crucial for clinical practice.
Purpose of the Study:
- To assess and compare the risk of GI bleeding in patients treated with rivaroxaban versus warfarin.
- To identify risk factors associated with GI bleeding in patients taking rivaroxaban.
Main Methods:
- Retrospective analysis of medical records for patients initiated on rivaroxaban or warfarin.
- Inclusion of 300 patients (147 rivaroxaban, 153 warfarin) between April 2011 and April 2013.
- Multivariate analysis to identify predictors of GI bleeding.
Main Results:
- Overall GI bleeding incidence was 4.8% for rivaroxaban and 9.8% for warfarin (p=0.094).
- Patients on rivaroxaban for ≤40 days had higher GI bleeding risk (OR=2.8, p=0.023).
- Concomitant dual antiplatelet agents (OR=7.4, p=0.0378) and prior GI bleeding (OR=15.5) were significant risk factors for rivaroxaban users.
Conclusions:
- Rivaroxaban and warfarin demonstrated similar rates of GI bleeding.
- Key risk factors for GI bleeding with rivaroxaban include early treatment duration (≤40 days), concurrent dual antiplatelet therapy, and a history of GI bleeding.
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