ArticleClinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
Improved Benefit Risk Profile of Rivaroxaban in a Subpopulation of the MAGELLAN Study.
Article in Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Standard- versus extended-duration anticoagulation for primary venous thromboembolism prophylaxis in acutely ill medical patients.The Cochrane database of systematic reviews · 2024Pooled it
- Scientific and Standardization Committee communication: Clinical guidance on the diagnosis, prevention, and treatment of venous thromboembolism in hospitalized patients with COVID-19.Journal of thrombosis and haemostasis : JTH · 2020Guideline
- Rivaroxaban for Prevention of Thrombotic Events, Hospitalization, and Death in Outpatients With COVID-19: A Randomized Clinical Trial.Circulation · 2023Trial
- Post-Discharge Prophylaxis With Rivaroxaban Reduces Fatal and Major Thromboembolic Events in Medically Ill Patients.Journal of the American College of Cardiology · 2020Trial
- Cystic fibrosis and sickle cell disease associated with nonadministration of VTE prophylaxis in hospitalized adults.Blood advances · 2026Article
- Anticoagulation and other risk factors for clinically relevant bleeding after medical hospitalization: the Medical Inpatient Thrombosis and Hemostasis Study.Journal of thrombosis and haemostasis : JTH · 2025Article
- Observational
- Leveraging machine learning for enhanced and interpretable risk prediction of venous thromboembolism in acute ischemic stroke care.PloS one · 2025Article
- Extended thromboprophylaxis in heart failure patients; the unmet need.Heart failure reviews · 2024Review
- To prophylax or not, and how much and how long? Controversies in VTE prevention for medical inpatients, including COVID-19 inpatients.Hematology. American Society of Hematology. Education Program · 2022Review
- Extended Thromboprophylaxis in Hospitalized Patients with Heart Failure: A Post Hoc Analysis of the MAGELLAN Study.TH open : companion journal to thrombosis and haemostasis · 2022Article
- Commentary on the 2021 ASH Guidelines on use of anticoagulation in patients with COVID-19 being discharged from the hospital.Blood advances · 2022Article
- Thromboembolic prevention and anticoagulant therapy during the COVID-19 pandemic: updated clinical guidance from the anticoagulation forum.Journal of thrombosis and thrombolysis · 2022Article
- Biomarker derived risk scores predict venous thromboembolism and major bleeding among patients with COVID-19.Research and practice in thrombosis and haemostasis · 2022Article
- Challenges of extended venous thromboembolism prophylaxis in medical and surgical patients.Jornal vascular brasileiro · 2022Review
- Thromboembolic events in COVID-19 ambulatory patients: An observational study about incidence, and thromboprophylaxis outcomes.PloS one · 2022Observational
- Medically Ill hospitalized Patients for COVID-19 THrombosis Extended ProphyLaxis with rivaroxaban ThErapy: Rationale and Design of the MICHELLE Trial.American heart journal · 2021Article
- Chronic intracardiac thrombus, a long-term complication of COVID-19: Case reports.Journal of cardiac surgery · 2021Article
- Randomized clinical trial to evaluate a routine full anticoagulation Strategy in Patients with Coronavirus Infection (SARS-CoV2) admitted to hospital: Rationale and design of the ACTION (AntiCoagulaTlon cOroNavirus)-Coalition IV trial.American heart journal · 2021Article
- Extended duration venous thromboembolism prophylaxis with betrixaban for patients re-admitted with venous thromboembolism.Journal of thrombosis and thrombolysis · 2021Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Acutely ill medical patients are at risk of venous thromboembolism (VTE) and VTE-related mortality during hospitalization and posthospital discharge, but widespread adoption of extended thromboprophylaxis has not occurred. We analyzed a subpopulation within the MAGELLAN study of extended thromboprophylaxis with rivaroxaban to reevaluate the benefit risk profile. We identified 5 risk factors for major and fatal bleeding after a clinical analysis of the MAGELLAN study and analyzed efficacy and safety with these patients excluded (n = 1551). Risk factors included: active cancer, dual antiplatelet therapy at baseline, bronchiectasis/pulmonary cavitation, gastroduodenal ulcer, or bleeding within 3 months before randomization. We evaluated efficacy, safety, and benefit risk using clinically comparable endpoints in the subpopulation. At day 10, rivaroxaban was noninferior to enoxaparin (relative risk [RR] = 0.82, 95% confidence interval [CI] = 0.58-1.15) and at day 35 rivaroxaban was significantly better than enoxaparin/placebo (RR = 0.68, 95% CI = 0.53-0.88) in reducing VTE and VTE-related death. Major bleeding was reduced at day 10 (RR = 2.18, 95% CI = 1.07-4.44 vs 1.19, 95% CI = 0.54-2.65) and at day 35 (2.87, 95% CI = 1.60-5.15 vs 1.48, 95% CI = 0.77-2.84) for MAGELLAN versus this subpopulation, respectively. The benefit risk profile was favorable in this subpopulation treated for 35 days, with the number needed to treat ranging from 55 to 481 and number needed to harm from 455 to 1067 for all pairwise evaluations. Five exclusionary criteria defined a subpopulation of acutely ill medical patients with a positive benefit risk profile for in-hospital and extended thromboprophylaxis with rivaroxaban.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.