Retrospective analysis of the efficacy and safety of rivaroxaban in the treatment of hepatic sinus obstruction syndrome caused by Gynura segetum

Background PA-HSOS is a rare disease and there is no specific treatment for PA-HSOS. Anticoagulant, antithrombotic and microcirculation therapy can alleviate the progression of PA-HSOS. The application of rivaroxaban in patients with PA-HSOS has not yet been reported. The aim of this study was to analyze the efficacy and safety of rivaroxaban in the treatment of pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndromecaused by Gynura segetum (PA-HSOS) . Methods A retrospective analysis was conducted with the clinical data of patients with PA-HSOS in the acute/subacute phase caused by taking Gynura segetum. The patients were divided into warfarin and rivaroxaban groups according to the anticoagulant therapy they received. Related biochemical indicators were monitored during hospitalization. Liver ultrasound, liver elastography and related biochemical indicators were reviewed every two weeks or one month after discharge. The patients were followed until 1 year after complete remission or death. The efficacy and safety of rivaroxaban was compared with that of warfarin according to the patients’ hepatic venous recanalization rates and the occurrence of bleeding events. Results The study included 20 patients, with 10 patients in the warfarin group and 10 patients in the rivaroxaban group. The results showed that the average anticoagulant course in the rivaroxaban group was significantly shorter than that in the warfarin group (P=0.007). With treatment, the remission rates of the rivaroxaban group and the warfarin group reached 90%. There was no significant difference in the incidence of adverse reactions or bleeding events between the two groups (P>0.05). Conclusions Compared with warfarin, rivaroxaban, a new oral anticoagulant, is convenient and safe for clinical use. It has an obvious effect on PA-HSOS and a low risk of bleeding. It provides a new anticoagulant treatment for PA-HSOS.