Treatment of atrial fibrillation and venous thromboembolism with factor Xa inhibitors in severely obese patients
Recommended Citation
Dobry P, Edwin SB, Haymart B, Barnes GD, Kaatz S, Ali MA, and Giuliano C. Treatment of Atrial Fibrillation and Venous Thromboembolism with Factor Xa Inhibitors in Severely Obese Patients. J Thromb Haemost 2024.
Document Type
Article
Publication Date
9-5-2024
Publication Title
Journal of thrombosis and haemostasis
Abstract
BACKGROUND: A paucity of data exists to support the use of factor Xa inhibitors in severely obese patients with a weight ≥ 150kg or BMI ≥ 50 kg/m(2).
OBJECTIVES: The purpose of this study is to evaluate whether factor Xa inhibitors are as safe and effective as warfarin for the treatment of atrial fibrillation (AF) and/or venous thromboembolism (VTE) in individuals with a BMI ≥ 50 kg/m(2) and/or weight ≥ 150 kg.
PATIENTS / METHODS: This was a multicenter retrospective cohort study of severely obese adult patients with AF and/or VTE treated with a factor Xa inhibitor or warfarin. The primary effectiveness outcome was a composite odds of stroke, systemic embolism or VTE; the primary safety outcome was odds of major bleeding. Secondary outcomes included incidence of stroke or systemic embolism, VTE, major bleeding, clinically relevant non-major bleeding, all-cause mortality, change in anticoagulation and total number of hospital encounters. Outcomes were assessed for 12 months following initiation of study drug.
RESULTS: A total of 1,736 patients were included. The mean weight and BMI of the overall cohort was 164.4 kg and 54.6 kg/m(2), respectively. There was no difference in odds of stroke, systemic embolism or VTE (OR 1.005, 95% CI 0.6 - 1.68) or major bleeding (OR 0.9, 95% CI 0.47 - 1.7) between groups.
CONCLUSIONS: These data suggest that apixaban and rivaroxaban are safe and effective alternatives to warfarin for the treatment of AF and/or VTE in individuals with a BMI ≥ 50 kg/m(2) and/or weight ≥ 150 kg.
PubMed ID
39243861
ePublication
ePub ahead of print
