中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 7
Jul.  2023
Turn off MathJax
Article Contents

Research advances in rivaroxaban in the treatment of portal vein thrombosis in liver cirrhosis

DOI: 10.3969/j.issn.1001-5256.2023.07.030
More Information
  • Corresponding author: ZHAO Dongqiang, hbzdq1998@163.com (ORCID: 0000-0003-3470-448X)
  • Received Date: 2022-10-12
  • Accepted Date: 2022-12-05
  • Published Date: 2023-07-20
  • Portal vein thrombosis (PVT) is one of the common complications of liver cirrhosis and is associated with the poor prognosis of liver disease. Rivaroxaban, a novel direct oral anticoagulant, exerts an antithrombotic effect by directly acting on the active center of factor Xa to inhibit the generation of thrombin, and it is a new choice for long-term anticoagulant treatment of PVT in liver cirrhosis with the advantages of direct oral administration and no need for international normalized ratio (INR) monitoring. In recent years, more and more clinical studies have shown that rivaroxaban is relatively safe and effective in the treatment of PVT in liver cirrhosis; however, there is still little experience in the application of rivaroxaban in the treatment of PVT in liver cirrhosis in the current clinical practice, and individualized medication regimen remains to be clarified. This article reviews the research advances in rivaroxaban in the treatment of PVT in liver cirrhosis, in order to provide new ideas for the clinical treatment of PVT in liver cirrhosis.

     

  • loading
  • [1]
    Hepatobiliary Disease Study Group, Chinese Society of Gastroenterology, Chinese Medical Association. Consensus for management of portal vein thrombosis in liver cirrhosis(2020, Shanghai)[J]. J Clin Hepatol, 2020, 36(12): 2667-2674. DOI: 10.3969/j.issn.1001-5256.2020.12.007.

    中华医学会消化病学分会肝胆疾病学组. 肝硬化门静脉血栓管理专家共识(2020年, 上海)[J]. 临床肝胆病杂志, 2020, 36(12): 2667-2674. DOI: 10.3969/j.issn.1001-5256.2020.12.007.
    [2]
    HUANG X, ABOUGERGI MS, SUN C, et al. Incidence and outcomes of thromboembolic and bleeding events in patients with liver cirrhosis in the USA[J]. Liver Int, 2023, 43(2): 434-441. DOI: 10.1111/liv.15325.
    [3]
    NORONHA FERREIRA C, MARINHO RT, CORTEZ-PINTO H, et al. Incidence, predictive factors and clinical significance of development of portal vein thrombosis in cirrhosis: A prospective study[J]. Liver Int, 2019, 39(8): 1459-1467. DOI: 10.1111/liv.14121.
    [4]
    SENZOLO M, GARCIA-TSAO G, GARCÍA-PAGÁN JC. Current knowledge and management of portal vein thrombosis in cirrhosis[J]. J Hepatol, 2021, 75(2): 442-453. DOI: 10.1016/j.jhep.2021.04.029.
    [5]
    GHABRIL M, AGARWAL S, LACERDA M, et al. Portal vein thrombosis is a risk factor for poor early outcomes after liver transplantation: analysis of risk factors and outcomes for portal vein thrombosis in waitlisted patients[J]. Transplantation, 2016, 100(1): 126-133. DOI: 10.1097/TP.0000000000000785.
    [6]
    YERDEL MA, GUNSON B, MIRZA D, et al. Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome[J]. Transplantation, 2000, 69(9): 1873-1881. DOI: 10.1097/00007890-200005150-00023.
    [7]
    MANTAKA A, AUGOUSTAKI A, KOUROUMALIS EA, et al. Portal vein thrombosis in cirrhosis: diagnosis, natural history, and therapeutic challenges[J]. Ann Gastroenterol, 2018, 31(3): 315-329. DOI: 10.20524/aog.2018.0245.
    [8]
    STINE JG, WANG J, SHAH PM, et al. Decreased portal vein velocity is predictive of the development of portal vein thrombosis: A matched case-control study[J]. Liver Int, 2018, 38(1): 94-101. DOI: 10.1111/liv.13500.
    [9]
    ABDEL-RAZIK A, MOUSA N, ELHELALY R, et al. De-novo portal vein thrombosis in liver cirrhosis: risk factors and correlation with the Model for End-stage Liver Disease scoring system[J]. Eur J Gastroenterol Hepatol, 2015, 27(5): 585-592. DOI: 10.1097/MEG.0000000000000325.
    [10]
    GIRLEANU I, STANCIU C, COJOCARIU C, et al. Natural course of nonmalignant partial portal vein thrombosis in cirrhotic patients[J]. Saudi J Gastroenterol, 2014, 20(5): 288-292. DOI: 10.4103/1319-3767.141687.
    [11]
    QI X, GUO X, YOSHIDA EM, et al. Transient portal vein thrombosis in liver cirrhosis[J]. BMC Med, 2018, 16(1): 83. DOI: 10.1186/s12916-018-1069-8.
    [12]
    LISMAN T, KAMPHUISEN PW, NORTHUP PG, et al. Established and new-generation antithrombotic drugs in patients with cirrhosis - possibilities and caveats[J]. J Hepatol, 2013, 59(2): 358-366. DOI: 10.1016/j.jhep.2013.03.027.
    [13]
    QI X, YANG Z, FAN D. Spontaneous resolution of portal vein thrombosis in cirrhosis: where do we stand, and where will we go?[J]. Saudi J Gastroenterol, 2014, 20(5): 265-266. DOI: 10.4103/1319-3767.141680.
    [14]
    European Association for the Study of the Liver. EASL clinical practice guidelines: vascular diseases of the liver[J]. J Hepatol, 2016, 64(1): 179-202. DOI: 10.1016/j.jhep.2015.07.040.
    [15]
    FRANCOZ C, BELGHITI J, VILGRAIN V, et al. Splanchnic vein thrombosis in candidates for liver transplantation: usefulness of screening and anticoagulation[J]. Gut, 2005, 54(5): 691-697. DOI: 10.1136/gut.2004.042796.
    [16]
    INTAGLIATA NM, CALDWELL SH, TRIPODI A. Diagnosis, development, and treatment of portal vein thrombosis in patients with and without cirrhosis[J]. Gastroenterology, 2019, 156(6): 1582-1599. e1. DOI: 10.1053/j.gastro.2019.01.265.
    [17]
    European Association for the Study of the Liver. EASL clinical practice guidelines on prevention and management of bleeding and thrombosis in patients with cirrhosis[J]. J Hepatol, 2022, 76(5): 1151-1184. DOI: 10.1016/j.jhep.2021.09.003.
    [18]
    SAMAMA MM. The mechanism of action of rivaroxaban—an oral, direct Factor Xa inhibitor—compared with other anticoagulants[J]. Thromb Res, 2011, 127(6): 497-504. DOI: 10.1016/j.thromres.2010.09.008.
    [19]
    TURPIE AG, KREUTZ R, LLAU J, et al. Management consensus guidance for the use of rivaroxaban—an oral, direct factor Xa inhibitor[J]. Thromb Haemost, 2012, 108(5): 876-886. DOI: 10.1160/TH12-03-0209.
    [20]
    KEARON C, AKL EA, ORNELAS J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report[J]. Chest, 2016, 149(2): 315-352. DOI: 10.1016/j.chest.2015.11.026.
    [21]
    AI MH, DONG WG, TAN XP, et al. Efficacy and safety study of direct-acting oral anticoagulants for the treatment of chronic portal vein thrombosis in patients with liver cirrhosis[J]. Eur J Gastroenterol Hepatol, 2020, 32(10): 1395-1400. DOI: 10.1097/MEG.0000000000001846.
    [22]
    de GOTTARDI A, TREBICKA J, KLINGER C, et al. Antithrombotic treatment with direct-acting oral anticoagulants in patients with splanchnic vein thrombosis and cirrhosis[J]. Liver Int, 2017, 37(5): 694-699. DOI: 10.1111/liv.13285.
    [23]
    HANAFY AS, ABD-ELSALAM S, DAWOUD MM. Randomized controlled trial of rivaroxaban versus warfarin in the management of acute non-neoplastic portal vein thrombosis[J]. Vascul Pharmacol, 2019, 113: 86-91. DOI: 10.1016/j.vph.2018.05.002.
    [24]
    LV Y, BAI W, LI K, et al. Anticoagulation and transjugular intrahepatic portosystemic shunt for the management of portal vein thrombosis in cirrhosis: a prospective observational study[J]. Am J Gastroenterol, 2021, 116(7): 1447-1464. DOI: 10.14309/ajg.0000000000001194.
    [25]
    KANG YN, SUN CY, ZHANG ZH, et al. Effect of rivaroxaban on acute portal vein thrombosis in patients with decompensated cirrhosis[J]. Henan Med Res, 2019, 28(4): 593-596. DOI: 10.3969/j.issn.1004-437X.2019.04.006.

    康艳楠, 孙长宇, 张致淏, 等. 利伐沙班对肝硬化失代偿期患者急性门静脉血栓的效果[J]. 河南医学研究, 2019, 28(4): 593-596. DOI: 10.3969/j.issn.1004-437X.2019.04.006.
    [26]
    HE YQ, JIANG WW, LIU YP. Efficacy analysis of rivaroxaban anticoagulant in the treatment of cirrhotic portal vein thrombosis and predictors of portal vein thrombosis recanalization[J]. J Binzhou Med Univ, 2022, 45(3): 171-176. DOI: 10.19739/j.cnki.issn1001-9510.2022.03.003.

    贺业群, 姜伟炜, 刘一品. 利伐沙班抗凝治疗肝硬化门静脉血栓的疗效分析以及门静脉血栓再通的预测因素[J]. 滨州医学院学报, 2022, 45(3): 171-176. DOI: 10.19739/j.cnki.issn1001-9510.2022.03.003.
    [27]
    XU X, GUO X, WANG R, et al. Low-molecular-weight heparin followed by rivaroxaban for acute occlusive portomesenteric vein thrombosis in a cirrhotic patient treated with multiple endoscopic variceal procedures[J]. Ann Hepatol, 2020, 19(5): 573-577. DOI: 10.1016/j.aohep.2019.08.002.
    [28]
    YANG H, KIM SR, SONG MJ. Recurrent acute portal vein thrombosis in liver cirrhosis treated by rivaroxaban[J]. Clin Mol Hepatol, 2016, 22(4): 499-502. DOI: 10.3350/cmh.2016.0016.
    [29]
    PONZIANI FR, DE CANDIA E, DE CRISTOFARO R, et al. Portal vein thrombosis occurrence in a cirrhotic patient during treatment with rivaroxaban[J]. Liver Int, 2017, 37(8): 1251. DOI: 10.1111/liv.13406.
    [30]
    YAO W, FENG Y, LIU T, et al. Rivaroxaban versus low-molecular weight heparin plus warfarin prevents portal vein system thrombosis after splenectomy and pericardial devascularization: A randomized clinical trial[J]. EXCLI J, 2021, 20: 537-549. DOI: 10.17179/excli2020-3120.
    [31]
    DU XF, WEI XH, QIU LX, et al. Safety of rivaroxaban in patients with decompensated cirrhosis[J]. Beijing Med. J, 2021, 43(7): 593-596. DOI: 10.15932/j.0253-9713.2021.07.001.

    杜晓菲, 韦新焕, 仇丽霞, 等. 失代偿期肝硬化患者应用利伐沙班的安全性研究[J]. 北京医学, 2021, 43(7): 593-596. DOI: 10.15932/j.0253-9713.2021.07.001.
    [32]
    INTAGLIATA NM, HENRY ZH, MAITLAND H, et al. Direct oral anticoagulants in cirrhosis patients pose similar risks of bleeding when compared to traditional anticoagulation[J]. Dig Dis Sci, 2016, 61(6): 1721-1727. DOI: 10.1007/s10620-015-4012-2.
    [33]
    COONS EM, STAUBES BA, CASEY AL, et al. Direct oral anticoagulants versus warfarin for treatment of thrombosis or atrial fibrillation in patients with cirrhosis: a retrospective cohort study[J]. Ann Pharmacother, 2022, 56(5): 533-540. DOI: 10.1177/10600280211025050.
    [34]
    LEE MC, LIAO CT, FENG IJ, et al. Recurrent thromboembolism, bleeding, and mortality in Asian patients with venous thromboembolism receiving different oral anticoagulants: A nationwide analysis[J]. Medicine (Baltimore), 2022, 101(37): e30412. DOI: 10.1097/MD.0000000000030551.
    [35]
    de GOTTARDI A, GARCIA-PAGAN JC, VALDIG Investigators. Risk of bleeding in cirrhotic patients treated with rivaroxaban[J]. Liver Int, 2017, 37(10): 1575-1576. DOI: 10.1111/liv.13543.
    [36]
    QI X, YOSHIDA EM, MENDEZ-SANCHEZ N, et al. Rivaroxaban recanalized occlusive superior mesenteric vein thrombosis, but increased the risk of bleeding in a cirrhotic patient[J]. Liver Int, 2017, 37(10): 1574-1575. DOI: 10.1111/liv.13511.
    [37]
    RUSSMANN S, NIEDRIG DF, BUDMIGER M, et al. Rivaroxaban postmarketing risk of liver injury[J]. J Hepatol, 2014, 61(2): 293-300. DOI: 10.1016/j.jhep.2014.03.026.
    [38]
    LIAKONI E, RÄTZ BRAVO AE, TERRACCIANO L, et al. Symptomatic hepatocellular liver injury with hyperbilirubinemia in two patients treated with rivaroxaban[J]. JAMA Intern Med, 2014, 174(10): 1683-1686. DOI: 10.1001/jamainternmed.2014.3912.
    [39]
    CALDEIRA D, BARRA M, SANTOS AT, et al. Risk of drug-induced liver injury with the new oral anticoagulants: systematic review and meta-analysis[J]. Heart, 2014, 100(7): 550-556. DOI: 10.1136/heartjnl-2013-305288.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(1)

    Article Metrics

    Article views (795) PDF downloads(121) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return