Efficacy and Safety of Rivaroxaban Versus Enoxaparin in Prevention of Recurrence of Venous Thrombo-Embolism Events in Cancer Patients: A Meta-Analysis

Author:

Awan Abdul Rafeh1ORCID,Ahmad Abdullah2,Daniyal Muhammad2,Khan Malik Muhammad Hamza3,Saeed Shaikh Jehanzaib3,Siddiqui Muhammad Bilal3,Hakeem Sheraz3,Shahab Azka4,Ali Syed Hasham5,Siddiqi Ahmed Kamal6

Affiliation:

1. Department of Medicine, Nishtar Medical University, Multan, Pakistan

2. Combined Military Hospital (CMH) Medical College, Lahore, Punjab

3. Department of Medicine, Aga Khan University, Karachi, Pakistan

4. Department of Medicine, Bahria University Medical and Dental College, Karachi, Pakistan

5. Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan

6. Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA

Abstract

Objective To examine the effectiveness of rivaroxaban compared to enoxaparin in patients diagnosed with cancer and venous thromboembolism. Methods A search of Pub Med, Scopus, and Google Scholar, from inception through April 2023 was conducted. Articles comparing rivaroxaban with enoxaparin in patients with cancer and VTE/PE/DVT were included. Review Manager Version 5.2 was utilised for the analysis of the following outcomes; VTE, PE, DVT, major bleeding, and mortality. Results A total of 8 articles and 2276 patients were included in the final analysis. Pooled analysis showed that rivaroxaban had a statistically insignificant reduced association with VTE occurrence (RR:0.83, 95% CI:0.58–1.18, P:0.3) as well as a statically insignificant reduction in major bleeding (RR:0.79, 95% CI:0.53–1.18, P:0.25). Analysis showcased that there was an insignificant reduction of mortality rivaroxaban as compared to enoxaparin (RR:0.74, 95% CI: 0.46–1.20, P:0.23). Conclusion Rivaroxaban can serve as a viable alternative to enoxaparin, with no appreciable drawbacks, for preventing and managing VTE in patients with malignancy.

Publisher

SAGE Publications

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