Author/Authors :
Yaghoubian, Jonathan M. College of Osteopathic Medicine of the Pacific - Western University of Health Sciences, Pomona, USA , Adashek, Jacob College of Osteopathic Medicine of the Pacific - Western University of Health Sciences, Pomona, USA , Yaghoubian-Yazi, Bahareh The Cardiovascular Institute of Greater Los Angeles, Tarzana, USA , Nagar, Menachem Faculty of Medicine - Technion-Israel Institute of Technology, Haifa, Israel , Toomari, Nojan Providence Tarzana Medical Center, Tarzana, USA , Pietras, Richard J. Department of Medicine - Division of Hematology-Oncology - David Geffen School of Medicine at UCLA, Los Angeles, USA , Ben-Zur, Uri M. Providence Tarzana Medical Center, Tarzana, USA
Abstract :
We present the case of a patient with a deep vein thrombosis (DVT) who failed rivaroxaban therapy. Our patient initially presented
with left lower extremity edema, erythema, and pain. He was subsequently started on rivaroxaban therapy for a combined treatment
period of 12 months, during and after which he persisted to have evidence of a DVT. The patient’s prescribed drug regimen was
changed from rivaroxaban to warfarin, which demonstrated a rapid resolution of the DVTs as determined by ultrasound assessment
of our patient’s lower extremity veins. Rivaroxaban, a factor Xa inhibitor, is a well-known oral anticoagulant that is used for a variety
of indications and has become a mainstay in the treatment of deep vein thrombosis. With the introduction and emergence of this
medication in the clinic, postmarketing reports of efficacy or lack thereof are important to review. In conclusion, we anticipate that
it is likely that there are other patients with DVTs who may not respond to rivaroxaban and for whom alternative anticoagulation
therapies should be explored.
