What is the role of edoxaban in the treatment of venous thromboembolism (VTE)?

Updated: Nov 05, 2020
  • Author: Vera A De Palo, MD, MBA, FCCP; Chief Editor: Vinod K Panchbhavi, MD, FACS  more...
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Answer

Edoxaban was approved by the FDA in January 2015 for treatment of DVT and PE in patients who have been initially treated with a parenteral anticoagulant for 5-10 days. Approval was based on the Hokusai-VTE study that included 4921 patients with DVT and 3,319 patients with PE.

Among patients with PE, 938 had right ventricular dysfunction, as assessed by measurement of N-terminal pro-brain natriuretic peptide (BNP) levels. [48] The rate of recurrent VTE in this subgroup was 3.3% in the edoxaban group and 6.2% in the warfarin group. Edoxaban was noninferior to high-quality standard warfarin therapy and caused significantly less bleeding in a broad spectrum of patients with VTE, including those with severe PE.

In a study of edoxaban for the treatment of cancer-associated VTE, 1050 patients were randomized to receive LMWH for at least 5 days followed by oral edoxaban (60 mg daily) or subcutaneous (SC) dalteparin (200 IU/kg body weight daily). Treatment was for 6 to 12 months. Edoxaban was noninferior to SC dalteparin for the composite outcome of recurrent VTE or major bleeding. The rate of recurrent VTE was lower, but the rate of major bleeding was higher with edoxaban. [49]


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