Abstract Number: PB2419
Meeting: ISTH 2020 Congress
Background: Anticoagulant therapy of DVT involves a risk of hemorrhagic complications. However, gender-related hemorrhages such as hypermenorrhea and menometrorrhagia is rarely taken into account.
Aims: Objective is assess the incidence of uterine bleeding during Rivaroxaban therapy.
Methods: In 3 years, we observe 72 women with DVT. All women are of reproductive age and have regular menstruation. The duration of thrombosis was from 3 to 36 months. All patients received Rivaroxaban 20mg/day.
The 19 women had the gynecological disorders such as endometriosis, uterus myoma and endometrial polyps. The 6 women had hypermenorrhea. All patients denied the presence of active menometrorrhagia until the development of venous thrombosis.
During Rivaroxaban therapy 32 (44.4%) patients indicated the development or progression of hypermenorrhea; and menometrorrhagia was in 7 of them (gynecological disorders in 34%).
Results: Rivaroxaban dose was reduced to 10mg/day in 3 women with a positive effect. In 15 women, Rivaroxaban dose was reduced to 10 mg/day only for menstruation, and 9 patients noted the decrease blood loss by flexible mode of anticoagulation.
Apixaban 5mg/day in 2 patients, Apixaban 10mg/day in 2 patients and Enoxaparin 40mg/day once daily in 1 case replaced Rivaroxaban. The reduced dose of alternative anticoagulant had a positive effect in all women. However, the stop of hypermenorrhea was only in 1 case of Apixaban 10mg/day. There was no recurrence of DVT in these patients during the observation period.
The anticoagulation was completed prematurely in 9 patients. After stop of Rivaroxaban therapy, thrombosis developed again in 1 woman with history of recurrent DVT.
Conclusions: The EINSTEIN DVT/PE subanalysis showed the development of uterine bleeding in 30.7% of women during Rivaroxaban therapy. The first results of “real practice” show a higher incidence of gender-associated hemorrhages (44.4%). In our opinion, it is necessary to continue accumulating data, possibly by an appropriate register.
To cite this abstract in AMA style:Dzhenina O, Bogachev V. Hypermenorrhea and Menometrorrhagia during Rivaroxaban Therapy [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/hypermenorrhea-and-menometrorrhagia-during-rivaroxaban-therapy/. Accessed November 30, 2021.
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