Xarelto (rivaroxaban) / J&J 
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  • ||||||||||  rivaroxaban / Generic mfg.
    Clinical, Journal:  Effectiveness and Safety of Rivaroxaban in Patients With Cancer-Associated Venous Thrombosis. (Pubmed Central) -  Nov 8, 2019   
    The cumulative incidence estimate was 4.0% (95% CI, 2.8%-5.4%) for recurrent VTE, 2.7% (95% CI, 1.7%-4.0%) for major bleeding, and 11.3% (95% CI, 9.2%-13.6%) for mortality/hospice care. Event rates observed in this rivaroxaban-treated cohort were overall consistent with previous studies of patients with rivaroxaban- and warfarin-managed CAT.
  • ||||||||||  Xarelto (rivaroxaban) / Bayer, J&J, aspirin / Generic Mfg., warfarin / Generic Mfg.
    Journal:  Novel Oral Anticoagulants in Peripheral Artery Disease. Current Evidence. (Pubmed Central) -  Nov 8, 2019   
    Compared with warfarin, both rivaroxaban treatment strategies had higher medication costs, but these were more than accounted for by fewer hospitalizations. For the time being, novel oral anticoagulants in combination with aspirin may provide an alternative treatment in PAD, however, it is deemed necessary to identify patient subgroups who will benefit the most.
  • ||||||||||  Xarelto (rivaroxaban) / Bayer, J&J
    Journal:  Rivaroxaban versus Clopidogrel for Peripheral Artery Disease: A Clinico-Economic Approach of the COMPASS trial. (Pubmed Central) -  Nov 8, 2019   
    Peripheral artery disease (PAD) is the third most common manifestation of atherosclerosis after coronary artery (CAD) and cerebrovascular disease (CVD).1 The progressive build-up of the plaque inside the arterial wall results in the impairment of blood flow that subsequently causes critical limb ischemia with resting pain, ulceration or gangrene. In most cases, people with PAD have plaque findings in other vascular territories as well and, thus, are at increased risk of major adverse cardiovascular or cerebrovascular events (MACCE), including myocardial infarction, and stroke.2 The vascular wall dysfunction, chronic inflammation, dyslipidaemia, metabolic abnormalities, hypercoagulability and increased platelet activity are the responsible mechanisms for these diseases.
  • ||||||||||  Xarelto (rivaroxaban) / Bayer, J&J, Eliquis (apixaban) / BMS
    Meta-Analysis and Cost-Effectiveness Analysis of Low-Dose Direct Oral Anticoagulant for the Prevention of Cancer Associated Thrombosis (Hall B, Level 2 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_6430;    
    It appears to be a cost-effective strategy for the prevention of CAT in intermediate-to-high risk ambulatory patients based on our analyses; however, the differential impact on QALY is small over lifetime . Future research should focus on a better understanding of the significance of these adverse events on longer term quality of life and their impact on delays in anti-cancer treatment.
  • ||||||||||  Imbruvica (ibrutinib) / AbbVie, J&J
    The Risk of Bleeding in Patients Receiving Ibrutinib Combined with Novel Direct Oral Anticoagulants (Hall B, Level 2 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_6059;    
    However, risk of bleeding is not neglectable, and treatment resumption in patients that experienced a significant bleeding event should be considered with caution. Note: Y. Herishanu and I. Avivi contributed equally to this work and are co-senior authors.
  • ||||||||||  Outcomes of Patients Receiving Direct Oral Anticoagulants for Myeloproliferative Neoplasm Associated Venous Thromboembolism (Hall B, Level 2 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_5923;    
    The median follow-up period was 2.2 years (range 0.7-7.5 years) with 16 patients initiated on DOAC (12 rivaroxaban and 4 apixaban) and 8 patients changed from VKA or heparin (3 rivaroxaban, 3 apixaban and 1 edoxaban)...There were no episodes of major bleeding but 2 patients (8.3%) had clinically relevant non-major bleeding both of which were taking aspirin in addition to DOAC...Of note, cytoreductive measures were also used in a majority of these patients. We suggest that DOACs could be safely used in this group in appropriately selected patients with MPN.
  • ||||||||||  Xarelto (rivaroxaban) / Bayer, J&J, warfarin / Generic mfg.
    The Role of Direct Oral Anticoagulants in Antiphospholipid Syndrome (Hall B, Level 2 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_5396;    
    The average duration from starting Rivaroxaban to development of complications such as bleeding and thromboembolic events was mostly after 1-2 years (70%). Conclusions Rivaroxaban should be used with extreme caution in APS patients, especially patients with a full positive aPL profile and arterial thrombosis.
  • ||||||||||  Xarelto (rivaroxaban) / Bayer, J&J, enoxaparin sodium / Generic mfg.
    Rivaroxaban and Extended Thromboprophylaxis in Acutely Ill Medical Patients with History of Cancer: Insights from the Magellan and Mariner Studies (Hall B, Level 2 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_5387;    
    P3
    In MAGELLAN, rivaroxaban appears more effective compared with enoxaparin/placebo in reducing the primary composite efficacy outcome in the subgroup with a history of cancer than those without cancer, whereas in MARINER, the reduction in symptomatic VTE and VTE-related death with rivaroxaban was similar in both subgroups. Although clinically relevant bleeding was increased in both studies, major bleeding was similar in those with a history of cancer in both studies and no fatal bleeding events were observed in the history of cancer subgroup in either study.
  • ||||||||||  Xarelto (rivaroxaban) / Bayer, J&J, Savaysa (edoxaban) / Daiichi Sankyo, Eliquis (apixaban) / BMS
    Patterns of VTE Treatment with Noac in Cancer Patients – Results of the Prospective Dresden Noac Registry (NCT01588119) (Hall B, Level 2 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_5383;    
    P=N/A
    Incidence rates of recurrent VTE and major bleeding were consistent with the results from recent randomized trials in CAT . Most VTE recurrences occurred after interruption or discontinuation of DOAC, which indicates the importance of continued therapy especially for patients with active cancer .
  • ||||||||||  Xarelto (rivaroxaban) / Bayer, J&J
    Net Clinical Benefit of Low Dose Rivaroxaban in Coronary Heart Disease: A Systematic Review and Meta-Analysis (Hall B, Level 2 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_5378;    
    Our data suggest that the use of rivaroxaban is associated with reduction in all-cause and cardiovascular mortality in coronary heart disease patients without significantly increasing the risk of bleeding. To further decrease the residual risk of cardiovascular events in coronary heart disease patients, low dose rivaroxaban can be considered by clinicians.
  • ||||||||||  doxorubicin hydrochloride / Generic mfg.
    Effectiveness and Safety of Direct Oral Anticoagulants Vs. Low Molecular Weight Heparin As Anticoagulant Therapy in Patients with Active Cancer Therapy and Non Valvular Atrial Fibrillation (Hall B, Level 2 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_5377;    
    Among all patients, 192 (63.5%) were treated with DOAC (20 dabigatran, 24 rivaroxaban, 80 apixaban and 68 edoxaban) and 110 with LMWH...Plasma concentrations were measured in 2 patients receiving dabigatran 110 mg twice daily and enzalutamide...Rivaroxaban plasma samples were collected in 3 patients who received doxorubicin as part of chemotherapy regimen...Meanwhile, determining DOAC plasma concentrations could be of profit to personalize anticoagulant therapy for patients with unpredictable drug interactions. Anticoagulation units play a crucial role in offering the best personalised therapy.
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, Portola Pharma, fondaparinux / Generic mfg.
    Administration of Andexanet Alfa for Direct Factor Xa Inhibitor Reversal Precludes Therapeutic Heparinization for Cardiopulmonary Bypass (Hall B, Level 2 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_5354;    
    Further, it poses an important safety concern as patients requiring emergent cardiac surgery are often hemodynamically unstable and delays in initiation of CPB due to inability to therapeutically heparinize following AnXa administration could adversely affect outcomes. We are currently evaluating whether the effects of AnXa on heparinization translate to increased thrombosis on CPB oxygenator membranes using an in vitro extracorporeal circulation model.
  • ||||||||||  aspirin / Generic mfg.
    Impact of Adding Aspirin to Direct Oral Anticoagulant Therapy without an Apparent Indication (Valencia BC (W415BC), Level 4 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_5086;    
    Further study is needed to assess if DOAC+ASA is safer than warfarin+ASA, to compare the outcomes of the individual DOACs, and to confirm these findings in a larger cohort. Until such assessment is complete, clinicians should carefully consider the need to add aspirin in patients on DOAC therapy.
  • ||||||||||  dexamethasone / Generic mfg.
    High Rates of Venous and Arterial Thrombotic Events in POEMS Patients: Results from the UK-Based POEMS Registry, Highlighting the Need for Therapeutic Guidelines (W414AB, Level 4 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_4993;    
    Lenalidomide and dexamethasone (LD) was the most common prescription 30/51 (59%), followed by cyclophosphamide and dexamethasone in 10/51 (20%), LD plus cyclophosphamide in 3/51 (6%), melphalan and steroids 3/51 (6%), cyclophosphamide, dexamethasone and thalidomide 2/51 (4%), LD plus ixazomib 1/51 (2%), velcade, thalidomide and dexamethasone 1/51 (2%) and carfilzomib with dexamethasone 1/51 (2%)...Other TP agents used include: aspirin (6/30), treatment dose LMWH (tLMWH) (2/30), rivaroxaban (2/30), warfarin (2/30) and clopidogrel (1/30)...Treatment comprised LMWH (4), warfarin (4), or the direct oral anticoagulants, rivaroxaban (1) and apixaban (1)...Three occurred on anti-POEMS therapy: one patient (VEGF 4555) developed a second stroke on LD and LMWH prophylaxis; one patient on LD (VEGF 10640) and prophylactic rivaroxaban 10mg developed PVD, and another on melphalan and prednisolone (VEGF 2000-4000) and warfarin for atrial fibrillation (target INR 2.0-3.0) developed PVD...Thromboprophylaxis is commonly used in POEMS patients receiving outpatient-based chemotherapy with the most common agent being prophylactic LMWH. With the high incidence of arterial events in the presence of active disease, the role for anti-platelet agents or indeed DOACs remains undefined in this patient group.
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, Portola Pharma, enoxaparin sodium / Generic mfg.
    Effects of Andexanet Alfa on Thrombin Generation in Bleeding Associated with Factor Xa Inhibitors (W414AB, Level 4 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_4990;    
    Thrombin generation at 8 h after andexanet bolus did not predict effective hemostasis, intracranial hematoma growth, or thrombotic events. This may be explained by the andexanet dose which was chosen to ensure full reversal of the factor Xa inhibitor in all patients.
  • ||||||||||  Predictors of Bleeding in the Perioperative Anticoagulant Use for Surgery Evaluation (PAUSE) Study (W414AB, Level 4 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_4989;    
    Results There were 3007 patients requiring perioperative DOAC interruption, distributed in the apixaban (A) (N = 1,257), dabigatran (D) (N = 668), and rivaroxaban (R) (N = 1,082) cohorts...[Hypertension (OR 3.93, 95%CI 1.40-11.07; p=0.010), active cancer (OR 2.30, 95% CI 1.10-4.81; p=0.026) were significantly associated with MB (table 3)] Aspirin use was more prevalent among males (13.78%) than females (7.75%), but this did not fully explain the gender effect...Nonetheless, we did not have power to analyze DOAC cohorts independently due to the paucity outcomes. Overall, the results strengthen the validity of the PAUSE-proposed DOAC interruption scheme for atrial fibrillation patients who need surgery.
  • ||||||||||  enoxaparin sodium / Generic mfg.
    Provider Practices Regarding Prophylactic Anticoagulation in Children with Leukemia (Hall B, Level 2 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_4619;    
    In addition, 36% use Apixaban and 14% use Rivaroxaban...Duration of anticoagulant therapy varies, and it is likely that there are no clear definitions regarding resolution of predisposing factors. Given their unique set of risk factors, and the potential morbidity associated with VTE, further study of VTE prophylaxis is essential for development of pediatric leukemia-specific guidelines.
  • ||||||||||  Xarelto (rivaroxaban) / Bayer, J&J, Eliquis (apixaban) / BMS
    Assessment of Provider Practices Regarding Management of VTE in Pediatric Leukemia (Hall B, Level 2 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_4605;    
    Recent ASH guidelines endorsed by the Children’s Oncology Group propose limited general guidelines and do not consider a cancer patient’s unique VTE risk profile . Given the variation seen, multi-center, prospective clinical trials are urgently needed for developing consensus guidelines for the management of VTE in children with leukemia.
  • ||||||||||  Xarelto (rivaroxaban) / Bayer, J&J, warfarin / Generic mfg., Eliquis (apixaban) / BMS
    Efficacy and Safety of Direct Oral Factor Xa Inhibitors in Patients after Bariatric Surgery (Hall B, Level 2 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_3599;    
    Although we had a relatively small sample size, the incidence of VTE recurrence was not higher in this cohort than was found in our previously published study of general obesity population. Prospective studies are needed to further investigate the efficacy and safety of direct oral anticoagulants in patients after bariatric surgery.
  • ||||||||||  Xarelto (rivaroxaban) / Bayer, J&J, Eliquis (apixaban) / BMS
    Treatment of Upper Extremity Deep Vein Thrombosis with Apixaban and Rivaroxaban (Hall B, Level 2 (Orange County Convention Center)) -  Nov 7, 2019 - Abstract #ASH2019ASH_3019;    
    This single institution prospective study adds to the limited experience with apixaban and rivaroxaban for acute UE-DVT. Treatment of UE-DVT with rivaroxaban and apixaban appears to be as safe and effective as LMWH/warfarin after 3 months of anticoagulation.