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Efficacy and safety of edoxaban for treatment of portal vein thrombosis following danaparoid sodium in patients with liver cirrhosis
Author(s) -
Nagaoki Yuko,
Aikata Hiroshi,
Daijyo Kana,
Teraoka Yuji,
Shinohara Fumi,
Nakamura Yuki,
Hatooka Masahiro,
Morio Kei,
Nakahara Takashi,
Kawaoka Tomokazu,
Tsuge Masataka,
Hiramatsu Akira,
Imamura Michio,
Kawakami Yoshiiku,
Ochi Hidenori,
Chayama Kazuaki
Publication year - 2018
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12895
Subject(s) - medicine , edoxaban , warfarin , warfarin sodium , cirrhosis , gastroenterology , surgery , anesthesia , dabigatran , atrial fibrillation
Aim To compare the efficacy and safety of edoxaban and warfarin for treatment of portal vein thrombosis (PVT) following danaparoid sodium in patients with liver cirrhosis. Methods Fifty cirrhotic patients with PVT treated initially for 2 weeks with danaparoid sodium were enrolled in this retrospective cohort study. Treatment was later switched to either edoxaban ( n = 20) or warfarin ( n = 30). We compared the efficacy and safety of edoxaban and warfarin for up to 6 months. The PVT volume was measured by dynamic computed tomography before treatment, at 2 weeks, and at 1, 3, and 6 months. Results There were no significant differences in the clinical characteristics of patients in the two groups. Treatment with edoxaban reduced the volume of PVT from 1.42 cm 3 at 2 weeks to 0.42 cm 3 at 6 months, and prevented exacerbation of PVT at 6 months after treatment with danaparoid sodium ( P = 0.016). In contrast, treatment with warfarin resulted in increased PVT volume from 1.73 cm 3 at 2 weeks to 2.85 cm 3 at 6 months, despite the control of the international normalized ratio in 57% of the patients ( P = 0.005). Multivariate regression analysis identified edoxaban therapy as the single significant and independent determinant of PVT reduction at 6 months ( P = 0.0014, hazard ratio 6.400). Clinically significant gastrointestinal bleeding was encountered in 3 of 20 (15%) patients of the edoxaban group and 2 of 30 (7%) of the warfarin group ( P = 0.335). Conclusion Edoxaban following danaparoid sodium is an effective anticoagulant and could be potentially considered as one of the treatment options for PVT in cirrhotic patients.