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Title: | Real-life Use of Anticoagulants in Venous Thromboembolism With a Focus on Patients With Exclusion Criteria for Direct Oral Anticoagulants | Authors: | Moustafa, Farès Pesavento, Raffaele di Micco, Pierpaolo González-Martínez, José Quintavalla, Roberto Peris, Maria-Luisa Porras, José Antonio Falvo, Nicolas Baños, Pilar Monreal, Manuel Bosevski M Zdraveska M |
Issue Date: | Apr-2018 | Publisher: | Wiley | Journal: | Clinical Pharmacology & Therapeutics | Abstract: | We assessed the real-life use of direct oral anticoagulants (DOACs) in patients with venous thromboembolism (VTE) and exclusion criteria for randomized trials. From 2013 to 2016, 3,578 of 18,853 patients (19%) had exclusion criteria. Irrespective of which anticoagulant was chosen, they had more VTE recurrences (hazard ratio (HR): 3.10; 95% confidence interval (CI): 2.47-3.88), major bleeds (HR: 4.10; 95% CI: 3.38-4.96), and deaths (HR: 9.47; 95% CI: 8.46-10.6) than those without exclusion criteria. During initial therapy, no patient with exclusion criteria on DOACs (n = 115) recurred, but those on rivaroxaban bled less often (adjusted HR: 0.18; 95% CI: 0.04-0.79) than those on unfractionated heparin (n = 224) and similar to those (n = 3,172) on low-molecular-weight (LMWH) heparin. For long-term therapy, patients on rivaroxaban (n = 151) had nonsignificantly fewer VTE recurrences (adjusted HR: 0.74; 95% CI: 0.08-1.32) and major bleeds (adjusted HR: 0.41; 95% CI: 0.15-1.15) than those on LMWH (n = 2,071). The efficacy and safety of DOACs were similar to standard therapy. | URI: | http://hdl.handle.net/20.500.12188/29249 | DOI: | 10.1002/cpt.781 |
Appears in Collections: | Faculty of Medicine: Journal Articles |
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