Efficacy and safety of edoxaban for the treatment of portal vein thrombosis in patients with cirrhosis

Abstract

Aim: This study evaluated the efficacy and safety of edoxaban in treating portal vein thrombosis (PVT) in patients with cirrhosis.

Methods: A total of 69 patients diagnosed with PVT secondary to cirrhosis were included. The therapeutic effect was assessed by measuring PVT volume using dynamic computed tomography (CT).

Results: The median PVT volume at baseline was 3.42 cm³, which significantly decreased to 1.01 cm³ after 3 months of treatment (p < 0.001). The combined complete response (CR) and partial response (PR) rate was 83% at 6 months and 95% at 1 year, with sustained reduction. Multivariate analysis identified D-dimer < 6.0 μg/ml (HR 6.9, p = 0.046) and absence of hepatic encephalopathy (HR 7.2, p = 0.042) as independent predictors of successful PVT reduction at 3 months. Clinically, bleeding events occurred in 20 of 69 patients (29%). Multivariate analysis revealed serum albumin < 3.2 g/dl (HR 4.612, p = 0.015) as an independent risk factor for bleeding. Liver function and fibrosis, assessed one year after edoxaban initiation using Child-Pugh, ALBI, and FIB-4 scores, showed no significant improvement.

Conclusion: Edoxaban appears to be an effective anticoagulant and may be considered a treatment option for PVT in patients with cirrhosis.