Effectiveness of edoxaban in portal vein thrombosis associated with liver cirrhosis

• Published in: Scientific reports Vol. 14; no. 1; p. 10784
• Main Authors: Tadokoro, Tomoko, Tani, Joji, Manabe, Takushi, Takuma, Kei, Nakahara, Mai, Oura, Kyoko, Mimura, Shima, Fujita, Koji, Nomura, Takako, Morishita, Asahiro, Kobara, Hideki, Himoto, Takashi, Ono, Masafumi, Masaki, Tsutomu
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 11-05-2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308; 692/4020/4021; Adult; Aged; Anticoagulants; Anticoagulants - therapeutic use; Bilirubin; Cirrhosis; Direct-acting oral anticoagulants; Factor Xa Inhibitors - therapeutic use; Female; Hepatocellular carcinoma; Humanities and Social Sciences; Humans; Liver cirrhosis; Liver Cirrhosis - complications; Liver Cirrhosis - drug therapy; Male; Medical prognosis; Middle Aged; multidisciplinary; Portal vein; Portal Vein - pathology; Portal vein thrombosis; Pyridines - adverse effects; Pyridines - therapeutic use; Retrospective Studies; Science; Science (multidisciplinary); Survival; Thiazoles - administration & dosage; Thiazoles - therapeutic use; Thromboembolism; Thrombolysis; Thrombosis; Treatment Outcome; Venous Thrombosis - drug therapy; Venous Thrombosis - etiology; Warfarin; Warfarin - adverse effects; Warfarin - therapeutic use; Cirrhosis; Warfarin; Direct-acting oral anticoagulants; Portal vein thrombosis
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-60235-y

Portal vein thrombosis (PVT) worsens the long-term prognosis of patients with cirrhosis; however, the optimal treatment remains to be determined. Reports on the efficacy of direct oral anticoagulants are increasing, and further evidence is needed. Therefore, we investigated the effectiveness of treatment with edoxaban in patients with PVT. We retrospectively reviewed the outcomes of edoxaban and warfarin as antithrombotic therapies for PVT. The median overall survival time was 4.2 years in patients with PVT, with a 1-year survival rate of 70.7% and a 5-year survival rate of 47.9%. The leading cause of death was hepatocellular carcinoma. The overall response rate for thrombolysis in the edoxaban group was 76.7% compared to 29.4% in the warfarin group, and edoxaban significantly improved PVT compared to warfarin. In addition, edoxaban provided long-term improvement of PVT. Warfarin, on the other hand, was temporarily effective but did not provide long-term benefits. The Child–Pugh and albumin-bilirubin scores did not change after edoxaban or warfarin use. No deaths occurred due to adverse events associated with edoxaban or warfarin. Edoxaban as a single agent can achieve long-term recanalization without compromising the hepatic reserves. Edoxaban is easy to initiate, even in an outpatient setting, and could become a major therapeutic agent for the treatment of PVT.