Treatment Patterns of Deep Vein Thrombosis and Pulmonary Embolism

Physicians are sticking with what they know when it comes to prescribing treatment for deep vein thrombosis (DVT) and pulmonary embolism (PE). A poster presented at the American Society of Hematology annual meeting found that the most common treatment remains parenteral anticoagulant (PAC) with warfarin despite the arrival of a the new treatment option rivaroxaban.

Researchers from Boston Health Economics Inc, and Boehringer Ingelheim Pharmaceuticals, Inc, studied hospital administrative claims data from more than 600 hospitals for patients age 18 years or older who had a primary discharge diagnosis of DVT and/or PE in order to evaluate characteristics and treatment patterns.

“Given the relatively recent introduction of novel oral anticoagulants (NOACs), it is essential to understand the demographic and clinical characteristics of DVT/PE patients receiving these therapies,” the authors wrote.

The study included 46,214 patients with 54% receiving the primary diagnosis of PE, 38% receiving the diagnosis of DVT without PE, and 8% receiving the diagnosis of DVT with secondary PE.

The most common treatment was PAC and warfarin (70%), followed by PAC alone (16%), then PAC and rivaroxaban (6%), PAC and warfarin and rivaroxaban (4%), wafarin alone (1%), rivaroxaban (1%), and no anticoagulant treatment (2%).

Using a logistic regression, the researchers determined that patients with a primary PE diagnosis, a primary DVT diagnosis with a secondary PE diagnosis, receipt of thrombolytic drugs, the presence of renal disease, and receipt of care in an urban hospital were significantly more likely to receive rivaroxaban with PAC and/or warfarin compared to rivaroxaban alone.

“Our findings indicate that the standard of care (PAC + warfarin) remains the dominant treatment regimen despite the availability of newer NOACs,” the authors concluded. “Future studies of treated patients with DVT and/or PE should examine whether these preliminary observations of treatment patterns change with increased clinical experience with NOACs.”