Randomized trial data suggest prophylactic rivaroxaban benefits these patients.
The two major complications of chronic portal-vein thrombosis (PVT) are gastrointestinal bleeding related to portal hypertension and recurrent thrombosis. However, the benefits and risks of anticoagulation therapy in patients with histories of PVT are not clear. In this French multicenter trial, 111 adults with noncirrhotic chronic PVT were randomized to rivaroxaban (15 mg daily) or no anticoagulation.
After 1 year, no thrombotic events had occurred in the rivaroxaban group, but 10 events had occurred in the control group (4 splanchnic vein thromboses, 3 deep venous thromboses, 3 pulmonary embolisms); the difference was highly significant. At this point, an independent data safety monitoring board recommended switching all study patients to …
Reviewing Author
DisclosuresConsultant/Advisory BoardNEJM Healer Advisory Group; Aquifer Clinical Excellence; NBME Clinical Reasoning
Grant/Research SupportSouthern Group on Educational Affairs (SGEA)
Editorial BoardsDiagnosis
Leadership Positions in Professional SocietiesUndergraduate Medical Education (UME) Section Chair, Southern Group on Educational Affairs (SGEA); Chair of Early Career Physicians, American College of Physicians (ACP), Virginia Chapter
DisclosuresConsultant/Advisory BoardNEJM Healer Advisory Group; Aquifer Clinical Excellence; NBME Clinical Reasoning
Grant/Research SupportSouthern Group on Educational Affairs (SGEA)
Editorial BoardsDiagnosis
Leadership Positions in Professional SocietiesUndergraduate Medical Education (UME) Section Chair, Southern Group on Educational Affairs (SGEA); Chair of Early Career Physicians, American College of Physicians (ACP), Virginia Chapter