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Published on: October 12, 2012
Effectiveness and safety of rivaroxaban for anticoagulation therapy in COVID-19: A meta-analysis of randomized
Xiangbo Shen1, Eryue Qiu1, Zhao Liu1
1From the Department of Pulmonary and Critical Care Medicine (Shen), Jiangxi PingXiang People's Hospital, Pingxiang, Jiangxi Province, from the Department of Trauma Center (Qiu, Zhu, Zeng); and from the Department of Critical Care Medicine (Liu), Zhuzhou Central Hospital, Zhuzhou, Hunan Province, China.
Insights
Rivaroxaban may reduce thrombotic events in COVID-19 patients, but it offers no significant advantage over heparin or LMWH and may increase bleeding risk. Further research is needed for optimal anticoagulation strategies.
Area of Science:
- Medical research
- Pharmacology
- Infectious diseases
Background:
- COVID-19 is associated with a high risk of thrombotic events.
- Anticoagulation is a key management strategy for COVID-19 patients.
- Rivaroxaban is an oral anticoagulant with potential use in COVID-19.
Purpose of the Study:
- To evaluate the effectiveness and safety of rivaroxaban for anticoagulation in COVID-19 patients.
- To compare rivaroxaban with other anticoagulants and placebo in randomized controlled trials.
Main Methods:
- Systematic search of PubMed, Embase, Cochrane Library, and ClinicalTrials.gov.
- Inclusion of 6 randomized controlled trials (RCTs) with 3323 patients.
- Data analysis focused on mortality, hospitalization, thrombotic, and bleeding events.
Main Results:
- Rivaroxaban did not significantly reduce all-cause mortality or hospitalization rates.
- Thrombotic events were reduced with rivaroxaban prophylaxis versus placebo.
- No significant difference in thrombotic event reduction between rivaroxaban and heparin/LMWH; potential increase in bleeding risk with rivaroxaban.
Conclusions:
- Rivaroxaban may reduce thrombotic events in COVID-19 but lacks superiority over heparin/LMWH.
- Rivaroxaban use may be associated with an increased risk of bleeding.
- The role of rivaroxaban in COVID-19 anticoagulation requires careful consideration of risks and benefits.
Objectives:
To evaluate the effectiveness and safety of rivaroxaban anticoagulation in COVID-19 patients.
Methods:
PubMed, Embase, Cochrane Library electronic databases, and ClinicalTrials.gov were searched to identify all relevant randomized controlled trial studies from December 2019 to July 2023.
Results:
A total of 6 randomized controlled trials, which included a total of 3323 patients, were considered for evaluation. Overall, short-term all-cause mortality and hospitalization rates were not significantly different between the rivaroxaban and control groups. Thrombotic events were significantly reduced in the rivaroxaban prophylaxis group compared to the placebo control group. However, the reduction in thrombotic events was not significantly different between rivaroxaban therapy and heparin or low-molecular-weight heparin (LMWH). Rivaroxaban prophylaxis and the therapeutic dose may be associated with a higher rate of overall bleeding rate, but major bleeding rates did not differ substantially.
Conclusion:
Rivaroxaban may reduce thrombotic events in COVID-19 patients, but it does not appear to have an advantage over heparin or LMWH, and it may increase the risk of bleeding.INPLASY Reg. No.: INPLASY 202370097.
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