RETRACTED: Randomized controlled trial of rivaroxaban versus warfarin in the management of acute non-neoplastic portal vein thrombosis

Direct Oral Anticoagulants in Patients with Liver Disease in the Era of Non-Alcoholic Fatty Liver Disease Global Epidemic: A Narrative Review

“…Several new studies have been published since the release of the latest guidelines [67] and previous reviews on the use of DOACs in patients with cirrhosis [5,[74][75][76]. Original studies evaluating the use of DOACs vs traditional anticoagulants in patients with CLD are reported in Table 1 [77][78][79][80][81][82][83][84][85][86][87][88][89].…”

“…In another retrospective cohort of 50 cirrhotic patients (CTP A/B/C 30/15/5) with PVT, treated initially for 2 weeks with LMWH and then switched to oral anticoagulation, a greater resolution of PVT at 6 months was found among patients on DOAC (edoxaban) as compared to those on warfarin, without significant differences in the incidence of bleeding, however, it should be noted that the dose of warfarin was in the sub-therapeutic range (INR target 1.5 to 2.0) [82]. Finally, a recent RCT on 80 patients with HCV-related compensated cirrhosis with acute PVT showed a higher rate of resolution of PVT and improved short-term survival without any complication, including major bleeding, in patients treated with low-dose rivaroxaban (10 mg every 12 h) as compared to those receiving warfarin [84].…”

Recent developments in the field of vascular liver diseases

“…Furthermore, head‐to‐head comparisons of these various agents are needed because of the markedly different pharmacokinetic profiles, as well as potential liver toxicity . One randomized but not blinded trial comparing warfarin with rivaroxaban for the treatment of portal vein thrombosis in patients with cirrhosis identified a clear advantage for rivaroxaban and one unblinded randomized controlled trial comparing rivaroxaban to placebo is ongoing in patients with non‐cirrhotic portal vein thrombosis (NCT02555111). Randomized double‐blind trials are also ongoing for the prophylactic treatment of portal vein thrombosis in patients with cirrhosis comparing rivaroxaban to placebo.…”

Portal Vein Thrombosis Prediction: Rebalanced Coagulation and Rethinking Anticoagulation

“…Finally, warfarin is an unattractive anticoagulation option given its narrow therapeutic window, long half-life, lack of a reversal agent, reliance on INR, and inferior efficacy. (8,9) However, the best type and optimal dose of anticoagulation in patients with cirrhosis remains unclear. With numerous direct oral anticoagulants available for use at prophylactic and therapeutic dosages, some with lower risk for bleeding than others, there is an urgent need to undertake further study of these medications in patients with cirrhosis both as prophylaxis and as treatment.…”

“…Finally, warfarin is an unattractive anticoagulation option given its narrow therapeutic window, long half‐life, lack of a reversal agent, reliance on INR, and inferior efficacy . However, the best type and optimal dose of anticoagulation in patients with cirrhosis remains unclear.…”