Edoxaban for the treatment of pulmonary embolism in hospitalized COVID-19 patients

Expert Rev Clin Pharmacol. 2021 Oct;14(10):1289-1294. doi: 10.1080/17512433.2021.1964359. Epub 2021 Aug 17.

Abstract

Purpose: We aimed to investigate the clinical performance of edoxaban for the treatment of pulmonary embolism (PE) in hospitalized COVID-19 patients.

Methods: We conducted a retrospective analysis selecting hospitalized patients with COVID-19 admitted to our Institution from 20 May 2020 to 20 November 2020 with computer tomography (CT) detected PE at admission, treated with edoxaban after initial parenteral therapy. Clinical outcomes were compared between patients with and without ARDS at admission and between those with and without CT confirmed PE resolution.

Results: 50 patients were included. Mean follow-up was 42.5 ± 10 days. No baseline differences were found between patients with ARDS (30%) and those without ARDS at admission. Patients with PE resolution (84%) were younger (P = 0.03), had a shorter duration of fondaparinux therapy (9.9 ± 3.8 vs 15.8 ± 7.5 days; P = 0.0015) and length of hospitalization (36 ± 8 vs 46 ± 9 days: P = 0.0023) compared with those without PE resolution. 2 patients experienced major bleedings. At multivariate analysis the time to edoxaban switch was the only predictor of the PE resolution (HR: 0.92; 95% C.I. 0.86 to 0.99).

Conclusion: Edoxaban was an effective and safe treatment for acute PE in COVID-19 setting.

Keywords: ARDS; COVID-19; SARS-CoV-2; edoxaban; efficacy; pulmonary embolism; safety.

MeSH terms

  • Adult
  • Aged
  • COVID-19 / complications*
  • Factor Xa Inhibitors / therapeutic use*
  • Female
  • Fondaparinux / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Proportional Hazards Models
  • Pulmonary Embolism / drug therapy*
  • Pulmonary Embolism / etiology
  • Pyridines / therapeutic use*
  • Respiratory Distress Syndrome
  • Retrospective Studies
  • SARS-CoV-2*
  • Thiazoles / therapeutic use*

Substances

  • Factor Xa Inhibitors
  • Pyridines
  • Thiazoles
  • Fondaparinux
  • edoxaban

Grants and funding

This paper was not funded.