May 17, 2021
Therapeutic-dose anticoagulation primarily consisting of rivaroxaban (Xarelto; Bayer/Janssen), compared with standard thromboprophylaxis, does not improve outcomes in patients hospitalized with COVID-19 who have elevated D-dimer levels, according to results from the randomized ACTION trial.
A “win ratio” analysis indicated that full-dose anticoagulation was no better, and potentially worse, than usual care in terms of a hierarchical composite endpoint of mortality, duration of hospitalization, and duration of oxygen use through 30 days, Renato Lopes, MD, PhD (Duke Clinical Research Institute, Durham, NC), reported over the weekend during the virtual American College of Cardiology 2021 Scientific Session.
A composite of thromboembolic events occurred at a numerically but nonsignificantly lower rate in the therapeutic-dose group (7.4% vs 9.9%), although that was offset by a nonsignificant increase in all-cause mortality (11.3% vs 7.6%) and a substantial and signific