Management of isolated distal deep–vein thrombosis with direct oral anticoagulants in the RIETE registry
| Autor: | José María Pedrajas, Jean-Philippe Galanaud, Manuel Monreal, Joaquín Alfonso, Aitor Ballaz, Laurent Bertoletti, Behnood Bikdeli, Javier Trujillo-Santos, Riete Investigators, Pierpaolo Di Micco, Cristiano Bortoluzzi |
|---|---|
| Přispěvatelé: | Galanaud, J. -P., Trujillo-Santos, J., Bikdeli, B., Di Micco, P., Bortoluzzi, C., Bertoletti, L., Pedrajas, J. M., Ballaz, A., Alfonso, J., Monreal, M., Tufano, A. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Deep vein 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Deep–vein thrombosis Venous thrombosis medicine 030212 general & internal medicine cardiovascular diseases Rivaroxaban Epidemiological studies business.industry Anticoagulant Factor-xa inhibitor Hematology medicine.disease Thrombosis Epidemiological studie Surgery Pulmonary embolism Regimen medicine.anatomical_structure Apixaban Cardiology and Cardiovascular Medicine business medicine.drug Deep–vein thrombosi |
| Zdroj: | JOURNAL OF THROMBOSIS AND THROMBOLYSIS r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante instname |
| ISSN: | 0929-5305 |
| Popis: | Isolated distal deep-vein thrombosis (DVT, infra-popliteal DVT without pulmonary embolism) is a common presentation of venous thromboembolism (VTE), but was an exclusion criterion from the pivotal trials that validated the use of direct oral anticoagulants (DOACs) for VTE management. Using data from the international RIETE registry, we analyzed and compared trends in DOACs prescription between January 2011 and June 2019 in patients with distal vs. proximal DVT. We also assessed DOACs' prescriptions and compared the outcomes (VTE recurrence, bleeding and death) of distal DVT patients treated with DOACs vs. those on vitamin K antagonists (VKAs). 2308 patients with distal DVT and 11,364 patients with proximal DVT were included in the current analysis. DOACs were more frequently prescribed in patients with distal than proximal DVT (25% vs. 16%, p < 0.001). DOACs use increased sharply during the observation period (P < 0.001 for trend). In 2018, 56% of patients with distal DVT received DOACs. Distal DVT patients treated with rivaroxaban or edoxaban received the dose recommended for VTE management in most (> 85%) cases. Patients treated with apixaban were older, more likely to have underlying conditions than patients treated with rivaroxaban and, in most cases (> 75%), did not receive the recommended 1-week loading dose for acute VTE management. Outcomes between distal DVT patients treated with VKAs or DOACs appeared to be similar. In patients with distal DVT, DOACs have become the most common anticoagulant regimen. Specific trials are needed to determine the optimal DOACs dose regimen for treatment of distal DVT. |
| Databáze: | OpenAIRE |
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