American Society of Hirudotherapy

Rivaroxaban for cancer-associated venous thromboembolism

Research article published in Science progress (2021)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Meta-analysisClinical TrialsLiang et al. · Science progress, 2021

Abstract

All cancers can increase the risk of developing venous thromboembolism (VTE), and anticoagulants should be considered as an optimal treatment for patients suffering from cancer-associated VTE. However, there is still a debate about whether the new oral anticoagulant, rivaroxaban, can bring better efficacy and safety outcomes globally. Thus, this systematic review and meta-analysis was conducted to evaluate the efficacy and safety of rivaroxaban. We searched PubMed, Cochrane Central Register of Controlled Trials, Web of Science, and China National Knowledge Infrastructure for relevant published papers before 1 September 2019, with no language restrictions. The primary outcomes are defined as the recurrence of VTE. The secondary outcomes are defined as clinically relevant non-major bleeding, adverse major bleeding events, and all-cause of death. The data were analyzed by Stata with risk ratio (RR) and 95% confidence interval (CI). Four trials encompassing 1996 patients were included. Rivaroxaban reduced recurrent VTE with no significant difference (RR = 0.68, 95% CI = 0.43-1.07). Similarly, there were no significant differences in adverse major bleeding events (RR = 0.86, 95% CI = 0.37-2.00), clinically relevant non-major bleeding (RR = 1.24, 95% CI = 0.73-2.12) and all-cause mortality (RR = 0.76, 95% CI = 0.40-1.44). In a selected study population of cancer patients with VTE, rivaroxaban is as good as other anticoagulants. Further, carefully designed randomized controlled trials should be performed to confirm these results.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleMeta-AnalysisResearch Support, Non-U.S. Gov'tSystematic Review
Indexed MeSH termsAdministration, OralAnticoagulantsHemorrhageHumansNeoplasmsRivaroxabanVenous Thromboembolism

Summary

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

This systematic review and meta-analysis pooled four trials (1996 patients) comparing the direct oral anticoagulant rivaroxaban with other anticoagulants for cancer-associated VTE, finding no statistically significant differences in recurrent VTE (RR 0.68, 95% CI 0.43-1.07), major bleeding, clinically relevant non-major bleeding, or all-cause mortality, and concluding rivaroxaban is 'as good as' other agents in this population. For the ASH evidence picture it maps the modern pharmacological anticoagulant landscape against which any biologically derived antithrombotic, including the leech-secretome anticoagulants that motivate hirudotherapy drug-discovery interest, would have to be benchmarked. The study examines a synthetic small-molecule oral drug and has no direct connection to leech therapy; its authors themselves note the included trials were few and call for further carefully designed randomized controlled trials to confirm the findings.

Citation

Rivaroxaban for cancer-associated venous thromboembolism.

Liang et al. · Science progress, 2021

DOI

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

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