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.
Резюме
Central venous catheters are prone to clotting, particularly in patients with cancer.
Почему это важно для гирудотерапии
This in vitro study compared apixaban, rivaroxaban, and enoxaparin for prevention of catheter-induced clotting and thrombin generation in human plasma using a microplate-based assay, finding that the direct oral anticoagulants were >20-fold less potent than enoxaparin at equivalent anti-factor Xa activity. The study highlights ongoing challenges in preventing catheter thrombosis, particularly in cancer patients. For ASH's domain, the relevance is only indirect—the study examines synthetic oral anticoagulants and low-molecular-weight heparin with no involvement of leeches, hirudin, or any leech-secretome component. The caveat is that this is an in vitro plasma assay with no leech-related content whatsoever; any connection to hirudotherapy would be purely speculative.
Цитирование
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
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
Добавлено в библиотеку ASH: May 27, 2026 · Последнее обновление сайта: June 18, 2026