Direct oral anticoagulants for extended thromboprophylaxis in medically ill patients: meta-analysis and risk/benefit assessment

• DOI: 10.2147/jbm.s149202
• Publication Date: 2018-02-20T18:28:04Z
• Authors: Majed Al Yami; Sawsan Kurdi; Ivo Abraham
• Keywords: Apixaban; Fondaparinux

Standard-duration (7-10 days) thromboprophylaxis with low molecular weight heparin, dose unfractionated or fondaparinux in hospitalized medically ill patients is associated ~50% reduction venous thromboembolism (VTE) risk. However, these remain at high risk for VTE post-discharge. The direct oral anticoagulants (DOACs) apixaban, rivaroxaban and betrixaban have been evaluated extended-duration (30-42 this population.We review the efficacy safety results from 3 pivotal trials of DOAC patients. We performed a meta-analysis focusing on 6 (efficacy) three bleeding outcomes (safety). These were integrated into quantitative risk/benefit assessment.The evaluating failed to establish clear and/or signals each agent. Our shows that, as class, DOACs selective partial prophylactic activity preventing events. marked increase various analyses fail show consistent net clinical benefit prophylaxis patients.At time, evidence safe effective population inconclusive.