Comparative evaluation of enoxaparin and rivaroxaban treatment outcomes in cancer patients with venous thromboembolism: a prospective cohort study

Document Type : Original Article

Authors

1 Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

10.22038/psj.2025.86223.1463

Abstract

Introduction:
The purpose of this study is to assess and compare the efficacy of Rivaroxaban and Enoxaparin in the management of Venous Thromboembolism (VTE) in cancer patients, as well as to evaluate potential risk factors associated with VTE recurrence.
Materials and Methods:
A retrospective cohort study design was employed, analyzing 402 patients above 18 years of age who were diagnosed with cancer and treated for VTE at Imam Reza and Ghaem hospitals between 2023 and 2024. Exclusion criteria were also set, and treatment regimens were detailed for both drugs. The analysis was conducted using chi-square tests, independent t-tests, and logistic regression.
Results:
The data revealed that Rivaroxaban was used more frequently than Enoxaparin, although the mean age was higher in the Enoxaparin group. No significant difference was observed in terms of VTE recurrence between the two drugs.
Conclusion:
The study concludes that Rivaroxaban and Enoxaparin are both effective in treating VTE in cancer patients. The selection of medication may depend on the specific characteristics of each patient.

Keywords

Main Subjects

References

  1. Yuk JS, Lee B, Kim MH, Kim K, Seo YS, Hwang SO, et al. Incidence and risk factors of VTE in patients with cervical cancer using the Korean national health insurance data. Sci Rep. 2021;11(1):8031.
  2. Khorana AA, Bauersachs RM, Kamphuisen PW, Meyer G, Janas MS, Jarner MF, et al. Clinical predictors of recurrent venous thromboembolism (VTE) in cancer patients from a randomized trial of long-term tinzaparin versus warfarin for treatment: The CATCH study. Journal of Clinical Oncology. 2015;33:9621-.
  3. Khorana AA. Risk assessment and prophylaxis for VTE in cancer patients. J Natl Compr Canc Netw. 2011;9(7):789-97.
  4. Yaghoubi MA, Mehrad-Majd H, Moradi A, Vakilzadeh MM, Khorasani ZM, Ghavi M, et al. The Prognostic Role of Corticosteroid Administration in Hospitalized Patients with Severe COVID-19: A Cross-sectional Study. Recent Advances in Inflammation & Allergy Drug Discovery. 2023;17(2):152-7.
  5. Streiff MB. Long-term therapy of venous thromboembolism in cancer patients. J Natl Compr Canc Netw. 2006;4(9):903-10.
  6. Mahé I, Elalamy I, Gerotziafas GT, Girard P. Treatment of Cancer-Associated Thrombosis: Beyond HOKUSAI. TH Open. 2019;3(3):e309-e15.
  7. Lee AY. Anticoagulation in the treatment of established venous thromboembolism in patients with cancer. J Clin Oncol. 2009;27(29):4895-901.
  8. Prandoni P, Piovella C, Filippi L, Vedovetto V, Dalla Valle F, Piccioli A. What are the pharmacotherapy options for treating venous thromboembolism in cancer patients? Expert Opin Pharmacother. 2014;15(6):799-807.
  9. Giustozzi M, Connors JM, Ruperez Blanco AB, Szmit S, Falvo N, Cohen AT, et al. Clinical characteristics and outcomes of incidental venous thromboembolism in cancer patients: Insights from the Caravaggio study. J Thromb Haemost. 2021;19(11):2751-9.
  10. Faqah A, Sheikh H, Bakar MA, Tayyaab F, Khawaja S. Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre. Thrombosis Journal. 2020;18(1):8.
  11. Prins MH, Lensing AW, Brighton TA, Lyons RM, Rehm J, Trajanovic M, et al. Oral rivaroxaban versus enoxaparin with vitamin K antagonist for the treatment of symptomatic venous thromboembolism in patients with cancer (EINSTEIN-DVT and EINSTEIN-PE): a pooled subgroup analysis of two randomised controlled trials. The Lancet Haematology. 2014;1(1):e37-e46.
  12. Wysokinski WE, Houghton DE, Casanegra AI, Vlazny DT, Bott‐Kitslaar DM, Froehling DA, et al. Comparison of apixaban to rivaroxaban and enoxaparin in acute cancer‐associated venous thromboembolism. American Journal of Hematology. 2019;94(11):1185-92.
  13. Simmons B, Wysokinski W, Saadiq RA, Bott‐Kitslaar D, Henkin S, Casanegra A, et al. Efficacy and safety of rivaroxaban compared to enoxaparin in treatment of cancer‐associated venous thromboembolism. European journal of haematology. 2018;101(2):136-42.
  14. Hummert SE, Gilreath J, Rodgers GM, Wilson N, Stenehjem DD. Comparative evaluation of the safety and effectiveness of rivaroxaban (riva) and enoxaparin (enox) for treatment of venous thromboembolism (VTE) in cancer patients. American Society of Clinical Oncology; 2017.
  15. Verso M, Agnelli G, Bertoglio S, Di Somma FC, Paoletti F, Ageno W, et al. Enoxaparin for the prevention of venous thromboembolism associated with central vein catheter: a double-blind, placebo-controlled, randomized study in cancer patients. Journal of Clinical Oncology. 2005;23(18):4057-62.



 

 

 

 

 

 

Journal of Patient Safety & Quality Improvement
Volume 13, Issue 3
July 2025
Pages 163-167

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