Superficial vein thrombosis–treatment and complications

Rivaroxaban offers patients with symptomatic superficial venous thrombosis a less burdensome and less expensive oral treatment option

Rivaroxaban, an oral factor Xa inhibitor, may simplify treatment compared with fondaparinux because it does not require daily subcutaneous injection and is less expensive. Efficacy outcomes were compared in patients with superficial venous thrombosis and additional risk factors who received either rivaroxaban or fondaparinux to determine whether rivaroxaban was noninferior to fondaparinux in preventing thromboembolic complications. 485 patients aged 18 years or older with symptomatic superficial venous thrombosis and at least one additional risk factor (older than 65 years, male sex, previous venous thromboembolism, cancer, autoimmune disease, thrombosis of nonvaricose veins) were enrolled, and 472 were randomly assigned to the rivaroxaban group (n=236) or the fondaparinux group (n=236). Rivaroxaban was noninferior to fondaparinux in the treatment of superficial vein thrombosis in the incidence of symptomatic deep vein thrombosis or pulmonary embolism, progression or recurrence of superficial vein thrombosis, and all-cause mortality and was not associated with more major bleeding. Therefore, rivaroxaban may offer patients with symptomatic superficial vein thrombosis a less burdensome and less expensive oral treatment option instead of a more expensive subcutaneous injection.

Prevention of thromboembolic complications in patients with superficial-vein thrombosis given rivaroxaban or fondaparinux: the open-label, randomised, non-inferiority SURPRISE phase 3b trial. Beyer-Westendorf J, Schellong SM, Gerlach H, Rabe E, Weitz JI, et al. Lancet Haematol. 2017 Mar;4(3):e105-e113.

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