rivaroxaban and Overweight

To review the literature on treatment of venous thromboembolism (VTE) and prevention of cardioembolic stroke with direct-acting oral anticoagulants (DOACs) in low- and high-body-weight patients and to make recommendations regarding agent selection and dosing in these patient populations.. The selection and optimal dosing of DOACs in low- and high-body-weight patients has not yet been fully elucidated by clinical trials; however, evidence suggests that issues of both safety and efficacy in patients at the extremes of body weight may warrant careful consideration when selecting a DOAC for such patients. This review provides a thorough discussion of the use of DOACs in the treatment of VTE and prevention of cardioembolic stroke in patients at the extremes of body weight and provides guidance regarding agent selection.. While the published evidence on use of DOACs in patients at extremes of body weight is sparse, apixaban and rivaroxaban appear to have the most favorable safety and efficacy profiles. Edoxaban and dabigatran should be avoided.

Topics: Anticoagulants; Body Weight; Dabigatran; Drug Dosage Calculations; Factor Xa Inhibitors; Humans; Obesity; Overweight; Pyrazoles; Pyridones; Rivaroxaban; Venous Thromboembolism

To investigate real-world prescribing trends and clinical outcomes based on body mass index (BMI) categorization in patients who received rivaroxaban therapy.. This was a retrospective cohort study involving all patients who received rivaroxaban therapy across all Hamad Medical Corporation (HMC) hospitals from 2015 to 2020.. Rivaroxaban prescribing has significantly increased over the years across general population, with a noticeable decline in obese population during the last few years (from 2018 onwards). Furthermore, an appreciable association was evident between all-cause mortality and BMI of these patients.

Topics: Anticoagulants; Atrial Fibrillation; Body Mass Index; Humans; Obesity, Morbid; Overweight; Retrospective Studies; Rivaroxaban; Thinness

Guidance for dabigatran and rivaroxaban in overweight patients diagnosed with non-valvular atrial fibrillation (NVAF) is still lacking.. Compare the effectiveness and safety of dabigatran and rivaroxaban for the treatment of NVAF in the overweight population.. A total of 396 out of 1029 overweight patients with NVAF at Zhongshan Hospital, Fudan University, from January 2017 and December 2018 were retrospectively enrolled using propensity score matching analysis. The clinical outcomes were analyzed by chi-square test and Kaplan-Meier analyses. The risk of bleeding and thrombosis was assessed using a Cox regression analysis and validated using a nomogram model.. Dabigatran therapy was shown to be equally effective. It may be superior in reducing bleeding risk in an overweight population with NVAF than rivaroxaban. Further prospective studies are encouraged for analysis.

Topics: Administration, Oral; Anticoagulants; Atrial Fibrillation; Dabigatran; Hemorrhage; Humans; Overweight; Prospective Studies; Retrospective Studies; Rivaroxaban; Stroke; Warfarin

Topics: Adult; Aged; Body Weight; Factor Xa Inhibitors; Female; Hemorrhage; Humans; Life Change Events; Male; Middle Aged; Overweight; Recurrence; Rivaroxaban; Treatment Outcome; Venous Thromboembolism