Rivaroxaban or Warfarin for Venous Thromboembolism Management in Obese Patients

In a recent study, Paige Weaver, from the Department of Pharmacy at the Ascension Genesys Hospital in Grand Blanc, Michigan, USA, and collaborating researchers assessed rivaroxaban or warfarin for management of venous thromboembolism (VTE) in morbidly obese patients—a population they felt had a dearth of available data. In their article in Annals of Pharmacotherapy, the authors relayed that they observed “no difference” between rivaroxaban or warfarin for the management of VTE in obese patients.

Rivaroxaban or Warfarin Study Design

The retrospective study included a total of 1,281 patients with acute VTE and morbid obesity, defined as weight over 120 kg or body mass index (BMI) over 40 kg/m², who were receiving rivaroxaban or warfarin. The primary efficacy endpoint of the analysis was the hazard of VTE recurrence, and the primary safety endpoint was the hazard of major bleeding events over a follow-up duration of 12 months.

Rivaroxaban or Warfarin Treatment Results

The study’s cohort had an average age of 57.6 ± 14.6 years, and an average weight of 136.4 ± 27.2 kg. According to the authors, “after controlling for confounding factors, the use of rivaroxaban was not associated with an increased hazard of VTE events when compared with warfarin (hazard ratio [HR] = 0.69; 95% confidence interval [CI], 0.42–1.08; p = 0.12) or major bleeding (HR = 1.29; 95% CI, 0.66–2.30; p = 0.52).”

The authors ultimately concluded that, for this subpopulation of morbidly obese patients with acute VTE, “either agent may be considered an appropriate treatment option.”

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