scholarly journals Health Care Costs among Patients Diagnosed with Deep Vein Thrombosis in the Outpatient Setting and Treated with Rivaroxaban Versus Low-Molecular-Weight Heparin and Warfarin

2016 ◽  
Vol 19 (3) ◽  
pp. A45-A46
Author(s):  
S Deitelzweig ◽  
F Laliberté ◽  
R Raut ◽  
G Germain ◽  
BK Bookhart ◽  
...  
Keyword(s):  
Health Care ◽  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Health Care Costs ◽  
Low Molecular Weight Heparin ◽  
Outpatient Setting ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Care Costs

Abstract 15386: Hospitalizations and Other Healthcare Resource Utilization Among Patients With Deep Vein Thrombosis Treated With Rivaroxaban versus Low-Molecular-Weight Heparin and Warfarin in the Outpatient Setting

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Steven Deitelzweig ◽  
François Laliberté ◽  
Monika Raut ◽  
Guillaume Germain ◽  
Brahim K Bookhart ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Resource Utilization ◽  
Low Molecular Weight Heparin ◽  
Healthcare Resource ◽  
Outpatient Setting ◽  
Healthcare Resource Utilization ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Deep Vein

Introduction: Compared with low-molecular-weight heparin (LMWH) and warfarin, the oral anticoagulant rivaroxaban has advantages such as simplified care that may lead to less healthcare resource utilization (HRU). Objective: To compare HRU (hospitalization, emergency room [ER], and outpatient [OP] visit) among deep vein thrombosis (DVT) patients who received rivaroxaban or LMWH/warfarin in the outpatient setting. Methods: A retrospective matched-cohort analysis was conducted using the Truven Health Analytic MarketScan Claims database from 1/2011-12/2013. Adult patients with a primary diagnosis of DVT during an OP/ER visit after November 02, 2012, and who initiated treatment on the same day with rivaroxaban or LMWH/warfarin were identified. Patients were observed within 1, 2, 3, and 4 weeks after their DVT diagnosis. Mean number of all-cause and VTE (DVT or PE)-related hospitalizations and other HRU were evaluated using Lin’s method. Results: All of the 512 rivaroxaban patients were well-matched with LMWH/warfarin patients. Mean all-cause number of hospitalizations was significantly lower for rivaroxaban compared to LMWH/warfarin users within 1 week (0.012 vs 0.032; P=0.044) and 2 weeks (0.022 vs 0.048; P=0.040), and numerically lower within 3 weeks (0.038 vs 0.061; P=0.112) and 4 weeks (0.045 vs 0.078; P=0.058). Corresponding mean number of VTE-related hospitalizations was significantly lower for rivaroxaban within 1 week (0.008 vs 0.028; P=0.020) and 2 weeks (0.016 vs 0.042; P=0.020), numerically lower within 3 weeks (0.030 vs 0.052; P=0.074), and significantly lower within 4 weeks (0.034 vs 0.068; P=0.036). Corresponding all-cause OP visits were significantly lower for rivaroxaban users, while ER visits were similar between cohorts (Table 1). Conclusion: DVT patients treated with rivaroxaban following an OP/ER visits had significantly fewer hospitalizations and outpatient visits during the first weeks compared to matched LMWH/warfarin users.

Comparison of a once Daily with a twice Daily Subcutaneous Low Molecular Weight Heparin Regimen in the Treatment of Deep Vein Thrombosis

1998 ◽  
Vol 79 (05) ◽  
pp. 897-901 ◽  
Author(s):  
Bernard A. Charbonnier ◽  
Jean-Noël Fiessinger ◽  
J. D. Banga ◽  
Ernst Wenzel ◽  
Pascal d’Azemar ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Daily Regimen ◽  
Once Daily ◽  
Daily Group ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryBackground: Clinical trials have been performed to compare with standard heparin a once or a twice daily regimen of low-molecular-weight heparin but no direct comparison has been done between these two low-molecular-weight heparin regimens in terms of efficacy and safety with a long-term clinical evaluation.Methods: Patients with proximal deep vein thrombosis, confirmed by venography were randomly assigned to either nadroparin (10,250 AXa IU/ml) twice daily or nadroparin (20,500 AXa IU/ml) once daily for at least 5 days. Regimens were adjusted to bodyweight. Oral anticoagulants were started on day 1 or 2 and continued for 3 months. Patients were followed up for 3 months. The composite outcome of venous thromboembolism and death possibly related to pulmonary embolism was the primary measure of efficacy. Major bleeding was the principal measure of safety. The study was designed to show equivalence between the two regimens.Results: Recurrent thromboembolic events or death possibly related to pulmonary embolism were reported in 13 patients in the once daily group (4.1%) and in 24 patients of the twice daily group (7.2%): (absolute difference 3.1% in favor of the once daily regimen; 95% confidence interval -6.6%, +0.5%). Major bleeding episodes during nadroparin treatment occurred in 4 (1.3%) and 4 patients (1.2%) in the once and twice daily groups, respectively.Conclusions: A nadroparin regimen of one injection per day is at least as effective and safe as the same total daily dose divided over two injections for the treatment of acute deep vein thrombosis.

scholarly journals Combination of Traditional Chinese Medicine and Low-Molecular-Weight Heparin Prevents Deep Vein Thrombosis After Surgery: A Meta-Analysis

2019 ◽  
Vol 25 ◽  
pp. 107602961989041
Author(s):  
Chu Chen ◽  
Qing Tang ◽  
Wenjuan Zhang ◽  
Huijun Yuan ◽  
Ying Huai ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Low Molecular Weight Heparin ◽  
Mean Difference ◽  
Combination Group ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Deep Vein

At present, there is no consistent understanding of the effect of traditional Chinese medicine (TCM) prescription in the prevention of the deep vein thrombosis (DVT), though TCM has been widely used in China. To evaluate the efficacy of TCM prescription combined with low-molecular-weight heparin (LMWH) for preventing DVT after major orthopedics surgery. All the retrieved articles were evaluated using specific inclusion and exclusion criteria. Then, data were extracted and evaluated for inclusion in a randomized controlled trial. In this study, variables included relative risk (RR), mean difference (MD), and their corresponding 95% confidence intervals (95% CIs). Overall, 16 articles were included with 1538 patients, 768 in the combination group (combination of TCM prescription and LMWH) and 770 in the LMWH group. The results indicated that in the combination group, the incidence of DVT (RR: 0.34, 95% CI: 0.23-0.50, P < .00001) and d-dimer levels (standardized mean difference: −1.19, 95% CI: −1.80 to −0.58, P = .0001) was significantly lower than that in the LMWH group. Furthermore, the combination treatment obviously decreased the concentration of fibrinogen (MD: −1.19, 95% CI: −2.13 to −0.25, P = .01). The combination of TCM prescription and LMWH could significantly reduce the incidence of DVT, suggesting that it may be a more effective prophylaxis measure for DVT after major orthopedics surgery.

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