Efficacy and Safety of Rivaroxaban versus Enoxaparin in the Treatment of Malignant Tumor Complicated with Venous Thromboembolism ：A Meta-analysis / 中国药房

ABSTRACT

OBJECTIVE：To compare the eff icacy and safety of rivaroxaban versus enoxaparin in the treatment of malignant tumor complicated with venous thromboembolism （VTE），and to provide evidence-based reference to the clinic. METHODS ： Retrieved from PubMed ，Embase，Cochrane Library ，Clinical Trials ，CNKI，CBM and VIP ，clinical trials or observational studies about rivaroxaban versus enoxaparin were collected during the inception to Apr. 2020. After literature screening and data extraction ， the quality of included literatures were evaluated by Newcastle Ottawa scale ；Stata 15.0 software was used to conduct Meta-analysis，sensitivity analysis and publication bias analysis. RESULTS ：A total of 5 observational clinical cohort studies were retrieved，including 4 retrospective cohort studies and one prospective cohort study. Totally 997 patients were included ，among which 625 patients received enoxaparin and 372 patients received rivaroxaban. Results of Meta-analysis showed that there was no statistical significance in recurrence rate of VTE at 3 months follow-up [RR ＝0.91，95％CI（0.50，1.66），P＝0.760] and 6 months follow-up [RR ＝0.53，95％CI（0.24，1.15），P＝0.106] as well as the incidence of massive hemorrhage at 3 months follow-up [RR ＝ 1.22 ，95％CI（0.66，2.25），P＝0.530] and 6 months follow-up [RR ＝1.30，95％CI（0.73，2.33），P＝0.368]. The results of sensitivity analysis showed that the results of above Meta-analysis were stable ；the results of publication bias analysis showed that there was less possibility of publication bias in this study. CONCLUSIONS ：Rivaroxaban is as effective and safe as enoxaparin in the treatment of malignant tumor with VTE.