Effectiveness and safety of rivaroxaban for anticoagulation therapy in COVID-19: A meta-analysis of randomized controlled trials

Xiangbo Shen; Eryue Qiu; Zhao Liu; Xiaopeng Zhu; Yiqian Zeng

doi:10.15537/smj.2024.45.4.20230728

References

1.↵
1. Sun Y,
2. Luo B,
3. Liu Y,
4. Wu Y,
5. Chen Y.
Immune damage mechanisms of COVID-19 and novel strategies in prevention and control of epidemic. Front Immunol 2023; 14: 1130398.
OpenUrl
2.↵
1. Vosko I,
2. Zirlik A,
3. Bugger H.
Impact of COVID-19 on cardiovascular disease. Viruses 2023; 15: 508.
OpenUrl CrossRef
3.↵
1. Ahmed SI,
2. Khan S.
Coagulopathy and plausible benefits of anticoagulation among COVID-19 patients. Curr Probl Cardiol 2020; 45: 100648.
OpenUrl
4.↵
1. Longchamp G,
2. Manzocchi-Besson S,
3. Longchamp A,
4. Righini M,
5. Robert-Ebadi H,
6. Blondon M.
Proximal deep vein thrombosis and pulmonary embolism in COVID-19 patients: a systematic review and meta-analysis. Thromb J 2021; 19: 15.
OpenUrl
5.↵
1. Ackermann M,
2. Verleden SE,
3. Kuehnel M,
4. Haverich A,
5. Welte T,
6. Laenger F, et al.
Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in COVID-19. N Engl J Med 2020; 383: 120-128.
OpenUrl CrossRef PubMed
6.↵
1. Knight R,
2. Walker V,
3. Ip S,
4. Cooper JA,
5. Bolton T,
6. Keene S, et al.
Association of COVID-19 with major arterial and venous thrombotic diseases: a population-wide cohort study of 48 million adults in England and Wales. Circulation 2022; 146: 892-906.
OpenUrl CrossRef PubMed
7.↵
1. Tang X,
2. Lyu WR,
3. Jin Y,
4. Wang R,
5. Li XY,
6. Li Y, et al.
Modern thromboprophylaxis protocol based on guidelines applied in a respiratory intensive care unit: a single-center prospective cohort study. Thromb J 2022; 20: 76.
OpenUrl
8.
1. Chandra A,
2. Chakraborty U,
3. Ghosh S,
4. Dasgupta S.
Anticoagulation in COVID-19: current concepts and controversies. Postgrad Med J 2022; 98: 395-402.
OpenUrl Abstract/FREE Full Text
9.↵
1. Farkouh ME,
2. Stone GW,
3. Lala A,
4. Bagiella E,
5. Moreno PR,
6. Nadkarni GN, et al.
Anticoagulation in patients with COVID-19: JACC review topic of the week. J Am Coll Cardiol 2022; 79: 917-928.
OpenUrl
10.↵
1. Cuker A,
2. Tseng EK,
3. Nieuwlaat R,
4. Angchaisuksiri P,
5. Blair C,
6. Dane K, et al.
American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: January 2022 update on the use of therapeutic-intensity anticoagulation in acutely ill patients. Blood Adv 2022; 6: 4915-4923.
OpenUrl
11.↵
1. Cuker A,
2. Tseng EK,
3. Nieuwlaat R, et al.
American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: May 2021 update on the use of intermediate-intensity anticoagulation in critically ill patients. Blood Adv 2021; 5: 3951-3959.
OpenUrl
12.↵
1. Brakta C,
2. Stépanian A,
3. Reiner P,
4. Delrue M,
5. Mazighi M,
6. Curis E, et al.
Practical nomogram predicting apixaban or rivaroxaban concentrations from low-molecular-weight heparin anti-xa values: special interest in acute ischemic stroke patients. J Stroke 2023; 25: 126-131.
OpenUrl
13.↵
1. Liu XQ,
2. Zhang YF,
3. Ding HY,
4. Yan MM,
5. Jiao Z,
6. Zhong MK, et al.
Population pharmacokinetic and pharmacodynamic analysis of rivaroxaban in Chinese patients with non-valvular atrial fibrillation. Acta Pharmacol Sin 2022; 43: 2723-2734.
OpenUrl
14.↵
1. Furtado RHM,
2. Macedo AVS,
3. Bronhara B,
4. Damiani LP
1. Lopes RD,
2. de Barros E Silva PGM
, Furtado RHM, Macedo AVS, Bronhara B, Damiani LP, et al. Therapeutic versus prophylactic anticoagulation for patients admitted to hospital with COVID-19 and elevated D-dimer concentration (ACTION): an open-label, multicentre, randomised, controlled trial. Lancet 2021; 397: 2253-2263.
OpenUrl CrossRef PubMed
15.
1. Ananworanich J,
2. Mogg R,
3. Dunne MW,
4. Bassyouni M,
5. David CV,
6. Gonzalez E, et al.
Randomized study of rivaroxaban vs Placebo on disease progression and symptoms resolution in high-risk adults with mild coronavirus disease 2019. Clin Infect Dis 2022; 75: e473-e481.
OpenUrl
16.
1. Ramacciotti E,
2. Barile Agati L,
3. Calderaro D,
4. Aguiar VCR,
5. Spyropoulos AC,
6. de Oliveira CCC, et al.
Rivaroxaban versus no anticoagulation for post-discharge thromboprophylaxis after hospitalisation for COVID-19 (MICHELLE): an open-label, multicentre, randomised, controlled trial. Lancet 2022; 399: 50-59.
OpenUrl CrossRef PubMed
17.
1. Rauch-Kröhnert U,
2. Puccini M,
3. Placzek M,
4. Beyer-Westendorf J,
5. Jakobs K,
6. Friebel J, et al.
Initial therapeutic anticoagulation with rivaroxaban compared to prophylactic therapy with heparins in moderate to severe COVID-19: results of the COVID-PREVENT randomized controlled trial. Clin Res Cardiol 2023; 112: 1620-1638.
OpenUrl
18.
1. Piazza G,
2. Spyropoulos AC,
3. Hsia J,
4. Goldin M,
5. Towner WJ,
6. Go AS, et al.
Rivaroxaban for prevention of thrombotic events, hospitalization, and death in outpatients with COVID-19: a randomized clinical trial. Circulation 2023; 147: 1891-1901.
OpenUrl
19.↵
1. Avezum Á,
2. Oliveira Junior HA,
3. Neves PDMM,
4. Alves LBO,
5. Cavalcanti AB,
6. Rosa RG, et al.
Rivaroxaban to prevent major clinical outcomes in non-hospitalised patients with COVID-19: the CARE - COALITION VIII randomised clinical trial. EClinicalMedicine 2023; 60: 102004.
OpenUrl
20.↵
1. Devreese KMJ,
2. de Groot PG,
3. de Laat B,
4. Erkan D,
5. Favaloro EJ,
6. Mackie I, et al.
Guidance from the Scientific and Standardization Committee for lupus anticoagulant/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis: Update of the guidelines for lupus anticoagulant detection and interpretation. J Thromb Haemost 2020; 18: 2828-2839.
OpenUrl CrossRef PubMed
21.↵
1. Hsia J,
2. Spyropoulos AC,
3. Piazza G,
4. Weng S,
5. Dunne MW,
6. Lipardi C, et al.
Antithrombotic prophylaxis with rivaroxaban in patients with prehospital COVID-19: a meta-analysis of 2 Placebo-controlled trials. Thromb Haemost 2023.
22.↵
1. Chen X,
2. Huang W,
3. Sun A,
4. Wang L,
5. Mo F,
6. Guo W.
Bleeding risks with novel oral anticoagulants especially rivaroxaban versus aspirin: a meta-analysis. Thromb J 2021; 19: 69.
OpenUrl
23.↵
1. Rinaldi I,
2. Amin IF,
3. Shufiyani YM,
4. Dewantara IR,
5. Edina BC,
6. Winston K, et al.
Comparison of the eficacy and safety of rivaroxaban and enoxaparin as thromboprophylaxis agents for orthopedic surgery-systematic review and meta-analysis. J Clin Med 2022; 11: 4070.
OpenUrl
24.↵
1. Huang HF,
2. Li SS,
3. Yang XT,
4. Xie Q,
5. Tian XB.
Rivaroxaban versus enoxaparin for the prevention of venous thromboembolism after total knee arthroplasty: a meta-analysis. Medicine (Baltimore) 2018; 97: e13465.
OpenUrl

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Keywords

[1] 1.↵
Sun Y,
Luo B,
Liu Y,
Wu Y,
Chen Y.
Immune damage mechanisms of COVID-19 and novel strategies in prevention and control of epidemic. Front Immunol 2023; 14: 1130398.
OpenUrl

[2] Sun Y,

[3] Luo B,

[4] Liu Y,

[5] Wu Y,

[6] Chen Y.

[7] 2.↵
Vosko I,
Zirlik A,
Bugger H.
Impact of COVID-19 on cardiovascular disease. Viruses 2023; 15: 508.
OpenUrl CrossRef

[8] Vosko I,

[9] Zirlik A,

[10] Bugger H.

[11] 3.↵
Ahmed SI,
Khan S.
Coagulopathy and plausible benefits of anticoagulation among COVID-19 patients. Curr Probl Cardiol 2020; 45: 100648.
OpenUrl

[12] Ahmed SI,

[13] Khan S.

[14] 4.↵
Longchamp G,
Manzocchi-Besson S,
Longchamp A,
Righini M,
Robert-Ebadi H,
Blondon M.
Proximal deep vein thrombosis and pulmonary embolism in COVID-19 patients: a systematic review and meta-analysis. Thromb J 2021; 19: 15.
OpenUrl

[15] Longchamp G,

[16] Manzocchi-Besson S,

[17] Longchamp A,

[18] Righini M,

[19] Robert-Ebadi H,

[20] Blondon M.

[21] 5.↵
Ackermann M,
Verleden SE,
Kuehnel M,
Haverich A,
Welte T,
Laenger F, et al.
Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in COVID-19. N Engl J Med 2020; 383: 120-128.
OpenUrl CrossRef PubMed

[22] Ackermann M,

[23] Verleden SE,

[24] Kuehnel M,

[25] Haverich A,

[26] Welte T,

[27] Laenger F, et al.

[28] 6.↵
Knight R,
Walker V,
Ip S,
Cooper JA,
Bolton T,
Keene S, et al.
Association of COVID-19 with major arterial and venous thrombotic diseases: a population-wide cohort study of 48 million adults in England and Wales. Circulation 2022; 146: 892-906.
OpenUrl CrossRef PubMed

[29] Knight R,

[30] Walker V,

[31] Ip S,

[32] Cooper JA,

[33] Bolton T,

[34] Keene S, et al.

[35] 7.↵
Tang X,
Lyu WR,
Jin Y,
Wang R,
Li XY,
Li Y, et al.
Modern thromboprophylaxis protocol based on guidelines applied in a respiratory intensive care unit: a single-center prospective cohort study. Thromb J 2022; 20: 76.
OpenUrl

[36] Tang X,

[37] Lyu WR,

[38] Jin Y,

[39] Wang R,

[40] Li XY,

[41] Li Y, et al.

[42] 8.
Chandra A,
Chakraborty U,
Ghosh S,
Dasgupta S.
Anticoagulation in COVID-19: current concepts and controversies. Postgrad Med J 2022; 98: 395-402.
OpenUrl Abstract/FREE Full Text

[43] Chandra A,

[44] Chakraborty U,

[45] Ghosh S,

[46] Dasgupta S.

[47] 9.↵
Farkouh ME,
Stone GW,
Lala A,
Bagiella E,
Moreno PR,
Nadkarni GN, et al.
Anticoagulation in patients with COVID-19: JACC review topic of the week. J Am Coll Cardiol 2022; 79: 917-928.
OpenUrl

[48] Farkouh ME,

[49] Stone GW,

[50] Lala A,

[51] Bagiella E,

[52] Moreno PR,

[53] Nadkarni GN, et al.

[54] 10.↵
Cuker A,
Tseng EK,
Nieuwlaat R,
Angchaisuksiri P,
Blair C,
Dane K, et al.
American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: January 2022 update on the use of therapeutic-intensity anticoagulation in acutely ill patients. Blood Adv 2022; 6: 4915-4923.
OpenUrl

[55] Cuker A,

[56] Tseng EK,

[57] Nieuwlaat R,

[58] Angchaisuksiri P,

[59] Blair C,

[60] Dane K, et al.

[61] 11.↵
Cuker A,
Tseng EK,
Nieuwlaat R, et al.
American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: May 2021 update on the use of intermediate-intensity anticoagulation in critically ill patients. Blood Adv 2021; 5: 3951-3959.
OpenUrl

[62] Cuker A,

[63] Tseng EK,

[64] Nieuwlaat R, et al.

[65] 12.↵
Brakta C,
Stépanian A,
Reiner P,
Delrue M,
Mazighi M,
Curis E, et al.
Practical nomogram predicting apixaban or rivaroxaban concentrations from low-molecular-weight heparin anti-xa values: special interest in acute ischemic stroke patients. J Stroke 2023; 25: 126-131.
OpenUrl

[66] Brakta C,

[67] Stépanian A,

[68] Reiner P,

[69] Delrue M,

[70] Mazighi M,

[71] Curis E, et al.

[72] 13.↵
Liu XQ,
Zhang YF,
Ding HY,
Yan MM,
Jiao Z,
Zhong MK, et al.
Population pharmacokinetic and pharmacodynamic analysis of rivaroxaban in Chinese patients with non-valvular atrial fibrillation. Acta Pharmacol Sin 2022; 43: 2723-2734.
OpenUrl

[73] Liu XQ,

[74] Zhang YF,

[75] Ding HY,

[76] Yan MM,

[77] Jiao Z,

[78] Zhong MK, et al.

[79] 14.↵
Furtado RHM,
Macedo AVS,
Bronhara B,
Damiani LP
Lopes RD,
de Barros E Silva PGM
, Furtado RHM, Macedo AVS, Bronhara B, Damiani LP, et al. Therapeutic versus prophylactic anticoagulation for patients admitted to hospital with COVID-19 and elevated D-dimer concentration (ACTION): an open-label, multicentre, randomised, controlled trial. Lancet 2021; 397: 2253-2263.
OpenUrl CrossRef PubMed

[80] Furtado RHM,

[81] Macedo AVS,

[82] Bronhara B,

[83] Damiani LP

[84] Lopes RD,

[85] de Barros E Silva PGM

[86] 15.
Ananworanich J,
Mogg R,
Dunne MW,
Bassyouni M,
David CV,
Gonzalez E, et al.
Randomized study of rivaroxaban vs Placebo on disease progression and symptoms resolution in high-risk adults with mild coronavirus disease 2019. Clin Infect Dis 2022; 75: e473-e481.
OpenUrl

[87] Ananworanich J,

[88] Mogg R,

[89] Dunne MW,

[90] Bassyouni M,

[91] David CV,

[92] Gonzalez E, et al.

[93] 16.
Ramacciotti E,
Barile Agati L,
Calderaro D,
Aguiar VCR,
Spyropoulos AC,
de Oliveira CCC, et al.
Rivaroxaban versus no anticoagulation for post-discharge thromboprophylaxis after hospitalisation for COVID-19 (MICHELLE): an open-label, multicentre, randomised, controlled trial. Lancet 2022; 399: 50-59.
OpenUrl CrossRef PubMed

[94] Ramacciotti E,

[95] Barile Agati L,

[96] Calderaro D,

[97] Aguiar VCR,

[98] Spyropoulos AC,

[99] de Oliveira CCC, et al.

[100] 17.
Rauch-Kröhnert U,
Puccini M,
Placzek M,
Beyer-Westendorf J,
Jakobs K,
Friebel J, et al.
Initial therapeutic anticoagulation with rivaroxaban compared to prophylactic therapy with heparins in moderate to severe COVID-19: results of the COVID-PREVENT randomized controlled trial. Clin Res Cardiol 2023; 112: 1620-1638.
OpenUrl

[101] Rauch-Kröhnert U,

[102] Puccini M,

[103] Placzek M,

[104] Beyer-Westendorf J,

[105] Jakobs K,

[106] Friebel J, et al.

[107] 18.
Piazza G,
Spyropoulos AC,
Hsia J,
Goldin M,
Towner WJ,
Go AS, et al.
Rivaroxaban for prevention of thrombotic events, hospitalization, and death in outpatients with COVID-19: a randomized clinical trial. Circulation 2023; 147: 1891-1901.
OpenUrl

[108] Piazza G,

[109] Spyropoulos AC,

[110] Hsia J,

[111] Goldin M,

[112] Towner WJ,

[113] Go AS, et al.

[114] 19.↵
Avezum Á,
Oliveira Junior HA,
Neves PDMM,
Alves LBO,
Cavalcanti AB,
Rosa RG, et al.
Rivaroxaban to prevent major clinical outcomes in non-hospitalised patients with COVID-19: the CARE - COALITION VIII randomised clinical trial. EClinicalMedicine 2023; 60: 102004.
OpenUrl

[115] Avezum Á,

[116] Oliveira Junior HA,

[117] Neves PDMM,

[118] Alves LBO,

[119] Cavalcanti AB,

[120] Rosa RG, et al.

[121] 20.↵
Devreese KMJ,
de Groot PG,
de Laat B,
Erkan D,
Favaloro EJ,
Mackie I, et al.
Guidance from the Scientific and Standardization Committee for lupus anticoagulant/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis: Update of the guidelines for lupus anticoagulant detection and interpretation. J Thromb Haemost 2020; 18: 2828-2839.
OpenUrl CrossRef PubMed

[122] Devreese KMJ,

[123] de Groot PG,

[124] de Laat B,

[125] Erkan D,

[126] Favaloro EJ,

[127] Mackie I, et al.

[128] 21.↵
Hsia J,
Spyropoulos AC,
Piazza G,
Weng S,
Dunne MW,
Lipardi C, et al.
Antithrombotic prophylaxis with rivaroxaban in patients with prehospital COVID-19: a meta-analysis of 2 Placebo-controlled trials. Thromb Haemost 2023.

[129] Hsia J,

[130] Spyropoulos AC,

[131] Piazza G,

[132] Weng S,

[133] Dunne MW,

[134] Lipardi C, et al.

[135] 22.↵
Chen X,
Huang W,
Sun A,
Wang L,
Mo F,
Guo W.
Bleeding risks with novel oral anticoagulants especially rivaroxaban versus aspirin: a meta-analysis. Thromb J 2021; 19: 69.
OpenUrl

[136] Chen X,

[137] Huang W,

[138] Sun A,

[139] Wang L,

[140] Mo F,

[141] Guo W.

[142] 23.↵
Rinaldi I,
Amin IF,
Shufiyani YM,
Dewantara IR,
Edina BC,
Winston K, et al.
Comparison of the eficacy and safety of rivaroxaban and enoxaparin as thromboprophylaxis agents for orthopedic surgery-systematic review and meta-analysis. J Clin Med 2022; 11: 4070.
OpenUrl

[143] Rinaldi I,

[144] Amin IF,

[145] Shufiyani YM,

[146] Dewantara IR,

[147] Edina BC,

[148] Winston K, et al.

[149] 24.↵
Huang HF,
Li SS,
Yang XT,
Xie Q,
Tian XB.
Rivaroxaban versus enoxaparin for the prevention of venous thromboembolism after total knee arthroplasty: a meta-analysis. Medicine (Baltimore) 2018; 97: e13465.
OpenUrl

[150] Huang HF,

[151] Li SS,

[152] Yang XT,

[153] Xie Q,

[154] Tian XB.

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Effectiveness and safety of rivaroxaban for anticoagulation therapy in COVID-19

A meta-analysis of randomized controlled trials

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Effectiveness and safety of rivaroxaban for anticoagulation therapy in COVID-19

A meta-analysis of randomized controlled trials

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