里瓦罗克萨班 预防非脊髓炎门静脉血栓症的预防方法
Aurélie Plessier1, Odile Goria2, Jean Paul Cervoni3
1Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Beaujon, Service d'Hépatologie, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, Filière de Santé des Maladies Rares du Foie, Valdig, ERN RARE-LIVER, Centre de Recherche sur l'Inflammation, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1149.
NEJM evidence
|February 6, 2024
概括
里瓦洛克萨班显著降低了非肝硬化慢性门静脉血栓症 (PVT) 患者的静脉血栓栓塞. 这种抗凝血疗法没有增加主要出血事件,为PVT患者提供了新的治疗选择.
科学领域:
- 心脏病学 心脏病学
- 肝病学 肝病学是一种肝病学.
- 血液学 血液学 血液学
背景情况:
- 非性慢性门静脉血栓塞 (PVT) 存在风险,长期抗凝效益尚不清楚.
- 评估利瓦洛克萨班在预防静脉血栓塞栓症 (VTE) 和管理与门高血压相关的出血方面的疗效至关重要.
研究的目的:
- 评估利瓦罗克萨班在减少非肝硬化慢性PVT患者静脉瘤风险方面的有效性.
- 为了确定里瓦洛克萨班是否会增加该患者群体中重大出血事件的风险.
主要方法:
- 一个多中心的受控试验随机分配了患有非肝硬化慢性PVT的患者,接受Rivaroxaban 15 mg/天或不接受抗凝药.
- 主要终点是2年无血栓生存期,次要终点包括局部特异性血栓和重大出血.
主要成果:
- 一项临时分析显示,使用里瓦洛克萨班的血栓发病率为每100人/年0人,而没有抗凝剂的血栓发病率为每100人/年19.71人/年 (P=0.0008).
- 在接受里瓦洛克萨班治疗的两名患者和一名不接受抗凝药治疗的患者中,经过平均30.3个月的随访后发生了严重出血. 没有报告死亡.
结论:
- 每日服用里瓦洛克萨班有效降低了非循环性慢性PVT患者的静脉瘤发病率.
- 里瓦罗克萨班并没有增加重大出血事件的风险,这表明其在这个队列中的安全性和有效性.
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