OC 44.2 - Recurrent venous thromboembolism after anticoagulation discontinuation in patients with isolated distal deep vein thrombosis: A post-hoc analysis of the RIDTS trial

Monday, June 24, 2024

15:00 – 15:15 ICT

Room: Ballroom B4

Presenting Author(s)

Nicola Potere, MD

Medical Resident
G. d'Annunzio University, Chieti, Italy
Chieti, Abruzzi, Italy

Co-Author(s)

LB

Lorenza Bertù

Statistician
Department of Medicine and Surgery, University of Insubria, Varese, Italy
Varese, Lombardia, Italy
Giuseppe Camporese

Assistant Professor
Padua University Hospital
Padova, Veneto, Italy
MI

Matteo Iotti

Medical Doctor
Cardiovascular Medicine Unit, AUSL-IRCCS, Reggio Emilia, Italy
Reggio Emilia, Emilia-Romagna, Italy
GL

Gianfranco Lessiani

Medical Doctor
Angiology Unit, Department of Internal Medicine, Villa Serena Hospital, Città Sant’Angelo, Italy
Città Sant'Angelo, Abruzzi, Italy
PP

Paolo Prandoni

MD, PhD
Fondazione Arianna
Padova, Veneto, Italy
MS

Michelangelo Sartori

Medical Doctor
Division of Angiology and Blood Coagulation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Bologna, Emilia-Romagna, Italy
AV

Adriana Visonà

Head of Angiology Unit
Azienda ULSS 2 Marca Trevigiana
Castelfranco Veneto, Veneto, Italy
EB

Elisabetta Bigagli

Pharmacist
Department of Neuroscience, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy
Florence, Toscana, Italy
GP

Gualtiero Palareti

Prof.
Arianna Foundation
Bologna, Emilia-Romagna, Italy
Walter Ageno, MD

Professor
University of Varese
Bellinzona, Ticino, Switzerland

Background: In the RIDTS trial, rivaroxaban treatment for 3 months safely and effectively reduced recurrent venous thromboembolism (VTE) as compared to 6 weeks in patients with symptomatic, non-cancer-associated, isolated distal deep vein thrombosis (IDDVT). Selected patient subgroups may exhibit a residually high long-term recurrence risk after treatment discontinuation.

Aims: To identify factors associated with recurrent VTE following treatment discontinuation in patients with symptomatic IDDVT enrolled in the RIDTS trial.

Methods: After receiving standard-dose rivaroxaban for 6 weeks or 3 months, 402 patients with symptomatic, non-cancer-associated IDDVT were followed-up for 2 years from the index event. The primary efficacy outcome was recurrent VTE.

Results: Overall, 62 (15.4%) patients experienced recurrent VTE throughout the study. All recurrent events occurred after treatment of index IDDVT was completed, consisting of 47 (75.8%) recurrent IDDVTs and 15 (24.2%) proximal deep vein thromboses or pulmonary embolisms. Mean time from treatment discontinuation to recurrence was 7.4±6.6 months. At univariable analysis, patients with recurrent VTE were more likely to be >65 years of age (OR, 1.84; 95%CI, 1.03-3.28), and to have diabetes (OR, 2.79; 95%CI, 1.15-6.78) or hypertension (OR, 1.78; 95%CI, 1.03-3.07) compared with patients without recurrent VTE (Table). Recurrent VTE occurred more frequently following unprovoked vs provoked IDDVT (OR, 3.45; 95%CI, 1.83-6.49), and in subjects treated for 6 weeks vs 3 months (OR, 1.81; 95%CI, 1.04-3.16). At multivariable analysis, diabetes (OR, 3.62; 95%CI, 1.11-11.77), unprovoked IDDVT (OR, 3.62; 95%CI, 1.11-11.77), and shorter treatment duration (OR, 3.31; 95%CI, 1.50-7.28) remained associated with recurrent VTE (Figure).

Conclusion(s): In the RIDTS trial, the long-term risk of VTE recurrence after treatment discontinuation was not negligible. Diabetes, unprovoked IDDVT and shorter length of anticoagulation were independently associated with an increased likelihood of recurrent VTE. Future studies should aim at identifying patient subgroups with IDDVT who might require longer treatment duration.