Comparison of the Efficacy and Safety of Rivaroxaban Versus Warfarin in Patients with or Susceptible to Thromboembolic Events

Abstract

Background: The similar efficacy of rivaroxaban and warfarin in thromboembolic events was recognized in clinical trials. But there are a few studies about the comparison of these medications in real world. This study was designed with the aim of comparing the efficacy and safety of the rivaroxaban and warfarin. Materials and Methods: All patients who received rivaroxaban or warfarin during April 2019 and October 2020 were recruited in the study. The major bleeding and thromboembolic events were considered as primary outcomes. Secondary outcomes were all cause mortality and minor bleeding. All of patients were followed for six months after recruitment and the end of study. Results: Of 242 patients recruited during the 18 months, 116 patients received rivaroxaban and 126 received warfarin. There were no significant differences between warfarin and rivaroxaban regarding major bleeding (p=0.24) and thromboembolic events (p=0.38). The minor bleeding was significantly higher in warfarin group. (29.36% versus 12.93%, p=0.002). The all-cause mortality rate was similar between two groups (p=0.67). More than 12% of patients were discontinued rivaroxaban, due to high cost. In warfarin group, 14.28% patients did not have compliance due to laboratory fluctuations and inappropriate access to medication. Conclusion: In the present study, warfarin and rivaroxaban had similar efficacy and safety. In addition, suitable compliance was observed in both groups.

Keywords

• rivaroxaban
• warfarin
• non-valvular atrial fibrillation
• thromboembolism