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Anticoagulant treatment for venous thromboembolism: A pooled analysis and additional results of the XALIA and XALIA-LEA noninterventional studies.
Haas, Sylvia; Mantovani, Lorenzo G; Kreutz, Reinhold; Monje, Danja; Schneider, Jonas; Zell, Elizabeth R; Tamm, Miriam; Gebel, Martin; Bugge, Jörg-Peter; Ageno, Walter; Turpie, Alexander G G.
Affiliation
  • Haas S; Formerly Technical University Munich Munich Germany.
  • Mantovani LG; IRCCS Multimedica Sesto San Giovanni Italy.
  • Kreutz R; CESP-Center for Public Health Research University of Milan Bicocca Monza Italy.
  • Monje D; Institute of Clinical Pharmacology and Toxicology Charité - Universitätsmedizin Berlin corporate member of Freie Universitä Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.
  • Schneider J; Bayer AG Berlin Germany.
  • Zell ER; Bayer AG Berlin Germany.
  • Tamm M; Stat-Epi Associates Inc. Ponte Vedra Beach FL USA.
  • Gebel M; Bayer AG Wuppertal Germany.
  • Bugge JP; Bayer AG Wuppertal Germany.
  • Ageno W; Bayer AG Berlin Germany.
  • Turpie AGG; Department of Clinical and Experimental Medicine University of Insubria Varese Italy.
Res Pract Thromb Haemost ; 5(3): 426-438, 2021 Mar.
Article in En | MEDLINE | ID: mdl-33870028
BACKGROUND: The XALIA and XALIA-LEA prospective, noninterventional studies investigated the safety and effectiveness of rivaroxaban versus standard anticoagulation for venous thromboembolism (VTE) treatment in routine clinical practice across global regions. OBJECTIVES: This pooled analysis combined their data to determine the incidence of thromboembolic and bleeding events in both treatment groups and addressed specific bleeding patterns in a broad range of patients. METHODS: Patients with objectively confirmed VTE and an indication for ≥3 months' anticoagulation treatment received rivaroxaban or standard anticoagulation (eg, initial treatment with heparin/fondaparinux, followed by a vitamin K antagonist [VKA]). Treatment choice, dose, management, and duration were at the physician's discretion. Primary outcomes (major bleeding, recurrent VTE, and all-cause mortality) were compared between the two treatment groups. Propensity score stratification, and matching were used to reduce bias due to confounding variables. RESULTS: Overall, 7129 patients were enrolled from 36 countries; 6445 and 2714 patients were included in the propensity score-stratified and -matched analyses, respectively. Major bleeding and incidences of recurrent VTE were similar between treatment groups; all-cause mortality was lower with rivaroxaban than with standard anticoagulation. The incidences of genitourinary bleeding were higher with rivaroxaban than with standard anticoagulation therapy (46 and 23 events in the matched analysis, respectively). VKA management in real-world practice was suboptimal. CONCLUSION: XALIA and XALIA-LEA show similar safety and effectiveness profiles of rivaroxaban and standard anticoagulation for VTE treatment in routine practice in many parts of the world. The observations are consistent with results from the phase III EINSTEIN randomized controlled trials.
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Full text: 1 Database: MEDLINE Type of study: Clinical_trials Language: En Year: 2021 Type: Article

Full text: 1 Database: MEDLINE Type of study: Clinical_trials Language: En Year: 2021 Type: Article