Rivaroxaban and apixaban are less effective than enoxaparin for the prevention of catheter-induced clotting invitro
Research article published in Journal of thrombosis and haemostasis : JTH (2022)
Abstract
BACKGROUND: Central venous catheters are prone to clotting, particularly in patients with cancer. Although low-molecular-weight heparin and direct oral anticoagulants, such as apixaban and rivaroxaban, have been evaluated for the prevention of catheter thrombosis, their efficacy remains uncertain. OBJECTIVES: Compare apixaban and rivaroxaban with enoxaparin for the prevention of catheter-induced clotting in vitro. METHODS: To address this uncertainty, we used a well-established microplate-based assay to compare the effects of enoxaparin, apixaban, and rivaroxaban on catheter-induced thrombosis and thrombin generation in human plasma. RESULTS: Consistent with our previous findings, catheter segments shortened the clotting time and promoted thrombin generation. When compared at concentrations with similar anti-factor Xa activity as enoxaparin, apixaban and rivaroxaban were >20-fold less potent than enoxaparin for the prevention of catheter-induced clotting and thrombin generation. CONCLUSION: The prevention of catheter thrombosis in patients with cancer is challenging. Clinical trials are needed to compare the efficacy of low-molecular-weight heparin with that of direct oral anticoagulants both for the prevention and treatment of catheter thrombosis.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Central venous catheters are prone to clotting, particularly in patients with cancer.
Por qué esto importa para la hirudoterapia
Este estudio in vitro comparó apixabán, rivaroxabán y enoxaparina para la prevención de la coagulación inducida por catéter y la generación de trombina en plasma humano mediante un ensayo basado en microplacas, encontrando que los anticoagulantes orales directos fueron más de 20 veces menos potentes que la enoxaparina a una actividad anti-factor Xa equivalente. El estudio pone de relieve los desafíos actuales en la prevención de la trombosis asociada a catéter, particularmente en pacientes oncológicos. Para el ámbito de la ASH, la relevancia es solo indirecta: el estudio examina anticoagulantes orales sintéticos y heparina de bajo peso molecular sin ninguna participación de sanguijuelas, hirudina ni de cualquier componente del secretoma de la sanguijuela. La advertencia es que se trata de un ensayo in vitro en plasma sin contenido alguno relacionado con sanguijuelas; cualquier conexión con la hirudoterapia sería puramente especulativa.
Citación
Rivaroxaban and apixaban are less effective than enoxaparin for the prevention of catheter-induced clotting invitro
Guan Z et al. · Journal of thrombosis and haemostasis : JTH, 2022
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026