Rivaroxaban Treatment for Heparin-Induced Thrombocytopenia: A Case Report and a Review of the Current Experience

Table 1

Cohort studies and case reports of rivaroxaban for the treatment of HIT.

Study reference	Number of patients	HITT	Rivaroxaban treatment for acute or subacute HIT	Primary or secondary treatment	Extension of thrombosis or major bleeding	Dose
[2, 9]	28	12/28	19/28 acute; 9/28 subacute	13/28 primary; 15/28 secondary	Yes^a,b	20/28 standard dose; 4/28 20 mg once daily; 4/28 10 mg once daily
[10, 11]^c	9	9/9	9/9 acute	9/9 primary	No	4/9 standard dose; 5/9 10 mg once daily
[12]	9^d	4/9	9/9 acute	9/9 secondary	No	9/9 20 mg once daily
[13]	3	2/3	3/3 acute	3/3 secondary	No	3/3 15 mg twice daily
[14]	2	2/2	2/2 acute	2/2 secondary	Yes^e	2/2 Standard dose
[15]	1	No	Acute	Secondary	No	Not specified
[16]	1	Yes	Acute	Secondary	No	Standard dose
[17]	1	Yes	Acute	Primary	No	20 mg twice daily
[18]	1	No	Acute	Primary	No	10 mg once daily
[19]	1	Yes	Acute	Primary	No	Standard dose
[20]	1	Yes	Acute	Secondary	No	Standard dose
[21]	1	Yes	Acute^f	Secondary	No	20 mg once daily
[22]	1	No	Acute	Primary	No	15 mg twice daily
[23]	1	Yes	Acute	Secondary	No	Not specified
[24, 25]^g	1	Yes	Acute	Primary	No	Standard dose
[26]	1	Yes	Subacute	Primary	No	10 mg once daily
[27]	1	Yes	Acute	Primary	No	Not specified
[28]	1	Yes	Acute	Secondary	No	Standard dose
[29]	1	Yes	Acute	Secondary	No	Not specified
Total (%)	65	40/65 (61.5%)	55/65 acute (84.6%); 10/65 subacute (15.4%)	29/65 primary (44.6%); 36/65 secondary (55.4%)	1/65 extension of thrombosis (1.5%); 1/65 major bleeding (1.5%)	33/65 standard dose (51%); 28/65 other doses (43%); 4/65 not specified (6%)
Our case	1	Yes	Subacute	Secondary	No	Standard dose

See text for details. ^aPossible extension of a catheter-related arm DVT with full recovery after catheter removal and despite the continuation of rivaroxaban. ^bOne rectal bleeding episode with a known gastric cancer occurred 9 days after discontinuing rivaroxaban and while receiving fondaparinux, so not included. ^cThe articles are combined because the 3 patients first reported by Ng et al. are also included among the 9 patients reported by Ong et al. ^dOut of the 11 patients who received rivaroxaban, 2 tested negative for HIT antibodies and thus are excluded in this table. ^eModerate hemoptysis secondary to known squamous cell lung cancer. ^fPlatelets dropped <50% but did not drop below 150 × 10⁹/L. ^gArticles in Spanish but data from Barlow et al.