Current use of rivaroxaban in elderly patients with venous thromboembolism (VTE)

J Thromb Thrombolysis. 2021 Oct;52(3):863-871. doi: 10.1007/s11239-021-02415-5. Epub 2021 Mar 5.

Abstract

Venous thromboembolism (VTE), which is characterized by pulmonary embolism and deep vein thrombosis, has become a serious public concern. Notably, over half of the patients with VTE are over 70 years of age, but elderly patients are at high risk of anti-coagulation and bleeding, which increase with age. Moreover, risk factors and frailty also show a difference between elderly patients and ordinary patients diagnosed with VTE. Rivaroxaban is a direct inhibitor of activated factor Xa and has the advantage of predictable pharmacodynamics and pharmacokinetics, no coagulation monitoring, and few drug interactions. As a first-line therapy for VTE, this drug is more advantageous than traditional therapy and exhibits good efficacy and safety for ordinary patients. However, the effectiveness and safety of rivaroxaban in elderly patients have not been fully elucidated. This article reviewed the use of rivaroxaban in elderly patients, including drug interactions, monitoring, reversal agents of rivaroxaban, and the use of small dosages of rivaroxaban in elderly patients.

Keywords: Deep vein thrombosis; Elderly patients; Pulmonary embolism; Rivaroxaban; Venous thromboembolism.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants
  • Factor Xa Inhibitors / adverse effects
  • Hemorrhage / chemically induced
  • Humans
  • Pulmonary Embolism*
  • Rivaroxaban / adverse effects
  • Venous Thromboembolism* / drug therapy
  • Venous Thrombosis*

Substances

  • Anticoagulants
  • Factor Xa Inhibitors
  • Rivaroxaban