Research progress of rivaroxaban in portal vein thrombosis in liver cirrhosis

Pan Yang; Xiaofeng Wang

doi:10.23977/medsc.2025.060411

Research progress of rivaroxaban in portal vein thrombosis in liver cirrhosis

Download as PDF

DOI: 10.23977/medsc.2025.060411 | Downloads: 7 | Views: 634

Author(s)

Pan Yang ¹, Xiaofeng Wang ²

Affiliation(s)

¹ Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
² Department of hepatology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712000, China

Corresponding Author

Xiaofeng Wang

ABSTRACT

Among the complications related to liver cirrhosis, portal vein thrombosis (PVT) occupies an important position and has a high incidence. As a new type of direct oral anticoagulant, rivaroxaban directly targets the active site of coagulation factor Xa and ultimately achieves the purpose of anticoagulation by inhibiting the activity of thrombin. Compared with traditional anticoagulants, rivaroxaban has more advantages and has been widely used in clinical practice. And a number of clinical studies have verified its efficacy and safety in the treatment of PVT in liver cirrhosis. This article reviews the application and progress of rivaroxaban in the treatment of portal vein thrombosis in liver cirrhosis, in order to help clinicians to improve their understanding of rivaroxaban anticoagulation.

KEYWORDS

Rivaroxaban; portal vein thrombosis in liver cirrhosis; research progress

CITE THIS PAPER

Pan Yang, Xiaofeng Wang, Research progress of rivaroxaban in portal vein thrombosis in liver cirrhosis. MEDS Clinical Medicine (2025) Vol. 6: 49-57. DOI: http://dx.doi.org/10.23977/medsc.2025.060411.

REFERENCES

[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]. Journal of Digestive Diseases, 2021, 22(4): 176-186.
[2] Noronha Ferreira C, Marinho R T, Cortez‐Pinto H, et al. Incidence, predictive factors and clinical significance of development of portal vein thrombosis in cirrhosis: a prospective study[J]. Liver International, 2019, 39(8): 1459-1467.
[3] Koh J H,Liew Z H,Ng G K,et al. Efficacy and safety of direct oral anticoagulants versus vitamin K antagonist for portal vein thrombosis in cirrhosis:a systematic review and meta-analysis[J]. Digestive and Liver Disease, 2022,54(1):56-62.
[4] Stine J G, Shah P M, Cornella S L, et al. Portal vein thrombosis, mortality and hepatic de-compensation in patients with cirrhosis:A meta-analysis[J].World journal of hepatology,2015,7(27):2774.
[5] Xu X, Guo X, De Stefano V, et al. Nonselective beta-blockers and development of portal vein thrombosis in liver cirrhosis: a systematic review and meta-analysis[J]. Hepatology international,2019,13:468-481.
[6] Shukla A, Giri S. Portal vein thrombosis in cirrhosis[J].Journal of clinical and experimental hepatology,2022,12 (3):965-979.
[7] Zocco M A, Di Stasio E, De Cristofaro R, et al. Thrombotic risk factors in patients with liver cirrhosis: correlation with MELD scoring system and portal vein thrombosis development[J]. Journal of hepatology,2009,51(4):682-689.
[8] Stine J G, Wang J, Shah P M, et al. Decreased portal vein velocity is predictive of the development of portal vein thrombosis:a matched case‐control study[J]. Liver Internatio-nal,2018,38(1):94-101.
[9] Turon F, Driever E G, Baiges A, et al. Predicting portal thrombosis in cirrhosis: a prospective study of clinical, ultrasonographic and hemostatic factors[J]. Journal of hepatology,2021,75(6):1367-1376.
[10] Northup P G, Garcia‐Pagan J C, Garcia‐Tsao G, et al. Vascular liver disorders, portal veinthrombosis, and procedural bleeding in patients with liver disease:2020 practice guidance by the American Association for the Study of Liver Diseases[J].Hepatology,2021,73(1):366-413.
[11] Envelope R D F P, Bosch J, Garcia-Tsao G, et al. Baveno VII–Renewing consensus in portal hypertension[J]. Journal of Hepatology,2022,76(4):959-974.
[12] Valeriani E, Di Nisio M, Riva N, et al. Anticoagulant treatment for splanchnic vein thrombosis in liver cirrhosis: a systematic review and meta-analysis[J].Thrombosis and hae-mostasis,2021,121(07):867-876.
[13] Dong S, Qi H, Li Y, et al. A systematic review and meta-analysis of anticoagulation therapy for portal vein thrombosis in patients with cirrhosis: to treat or not to treat?[J].Hepatology International,2021:1-20.
[14] Wang L, Guo X, Xu X, et al. Anticoagulation favors thrombus recanalization and survival in patients with liver cirrhosis and portal vein thrombosis: results of a meta-analysis[J].Advances in Therapy,2021,38:495-520.
[15] DONG Ruo-Nan, ZHAO Kai, GUAN Jia-Lun, et al. Progress of anticoagulation therapy in portal vein thrombosis in liver cirrhosis[J]. Journal of Emergency and Critical Care in Internal Medicine,2024,30(01):83-87.
[16] Priyanka P, Kupec J T, Krafft M, et al. Newer Oral Anticoagulants in the Treatment of Acute Portal Vein Thrombosis in Patients with and without Cirrhosis[J]. International Journal of Hepatology, 2018,2018:1-9.
[17] Caldeira D, Barra M, Santos A T, 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.
[18] Villa E, Bianchini M, Blasi A, et al. EASL Clinical Practice Guidelines on prevention and management of bleeding and thrombosis in patients with cirrhosis[J]. Journal of hepatology,2022,76(5):1151-1184.
[19] O'Leary J G, Greenberg C S, Patton H M, et al. AGA clinical practice update: coagulate-on in cirrhosis[J]. Gastroenterology, 2019, 157(1): 34-43.e1.
[20] Zhou H, Wu M, Yu S, et al. Comparison of the efficacy and safety between rivaroxaban and dabigatran in the treatment of acute portal vein thrombosis in cirrhosis[J]. BMC gastroenterology, 2023, 23(1):329.
[21] Guo Y, Dong S, Li M, et al. A new model of portal vein thrombosis in rats with cirrho-sis induced by partial portal vein ligation plus carbon tetrachloride and intervened with rivaroxaban[J]. BMC gastroenterology,2024,24(1):161.
[22] FENG Yongan, ZHANG Rui, YAO Wei, et al. Application effect of rivaroxaban in the prevention of PVT after splenectomy for liver cirrhosis[J]. Clinical Medicine Research and Practice, 2024,9(12):35-38.
[23] HE Yequn, JIANG Weiwei, LIU Yipin. Efficacy analysis of rivaroxaban anticoagulant in the treatment of cirrhotic portal vein thrombosis and predictors of portal vein thrombosis recanalization[J]. Journal of Binzhou Medical College, 2022, 45(03):171-176.
[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]. Official journal of the American College of Gastroenterology| ACG, 2021, 116(7): 1447-1464.
[25] Intagliata N M, Henry Z H, Maitland H, et al. Direct oral anticoagulants in cirrhosis patients pose similar risks of bleeding when compared to traditional anticoagulation[J]. Digestive diseases and sciences, 2016, 61: 1721-1727.
[26] Ai M, Dong W, Tan X, 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]. European Journal of Gastroenterology & Hepatology, 2020, 32(10): 1395-1400.
[27] LIU Shuang, ZHAO Dongqiang. Research advances in rivaroxaban in the treatment of portal vein thrombosis in liver cirrhosis [J]. Journal of Clinical Hepatobiliary Diseases,2023,39(07):1721-1727.
[28] Mort J F, Davis J P E, Mahoro G, et al. Rates of bleeding and discontinuation of d-irect oral anticoagulants in patients with decompensated cirrhosis[J]. Clinical Gastroen-terology and Hepatology, 2021, 19(7): 1436-1442.
[29] WANG Shimei, WU Liping, HU Ling. Advances in direct oral anticoagulants in the treatment of cirrhosis-associated portal vein thrombosis[J]. Journal of Clinical Hepatobiliary Diseases,2023,39(01):199-204.
[30] Zhou Haonan. Comparison of the efficacy and safety between rivaroxaban and dabigatran in the treatment of acute portal vein thrombosis cirrhosis[D]. Chongqing Medical University,2023.
[31] Coons E M, Staubes B A, Casey A L, et al. Direct oral anticoagulants versus warfarin for treatment of thrombosis or atrial fibrillation in patients with cirrhosis: a retrospective cohort study[J]. Annals of Pharmacotherapy,2022,56(5): 533-540.
[32] DU Xiaofei, WEI Xinhuan, QIU Lixia, et al. Safety of rivaroxaban in patients with decompensated cirrhosis[J]. Beijing Medicine, 2021, 43(07): 593-596.
[ 33] ZHANG Li, WANG Haiyan, WANG Yanfang, et al. Observation on the effect of oral anticoagulation therapy with rivaroxaban in patients with Child-Pugh class B cirrhosis combined with portal vein thrombosis[J]. China Drugs and Clinics,2021,21(01):97-99.
[ 34] Hum J, Shatzel J J, Jou J H, et al. The efficacy and safety of direct oral anticoagulants vs traditional anticoagulants in cirrhosis[J]. European journal of haematology, 2017, 98(4): 393-397.
[35] Rodriguez-Castro K I, Vitale A, Fadin M, et al. A prediction model for successful anticoagulation in cirrhotic portal vein thrombosis[J]. European journal of gastroenterology & hepatology, 2019, 31(1): 34-42.
[36] Delgado M G, Seijo S, Yepes I, et al. Efficacy and safety of anticoagulation on patients with cirrhosis and portal vein thrombosis[J]. Clinical gastroenterology and Hepatology, 2012, 10(7): 776-783.
[37] 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 journal, 2021, 20: 537.
[38] Ponziani F R, 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.

Subscription

E-Mail Alert

Downloads:	9213
Visits:	555725

Research progress of rivaroxaban in portal vein thrombosis in liver cirrhosis

Author(s)

Affiliation(s)

Corresponding Author

ABSTRACT

KEYWORDS

CITE THIS PAPER

REFERENCES

RESOURCES

JOIN US

PUBLICATION SERVICES

CONTACT US