Oral direct thrombin inhibitors or oral factor Xa inhibitors versus conventional anticoagulants for the treatment of deep vein thrombosis

Direct oral anticoagulants versus conventional anticoagulants for deep vein thrombosis

“…There are several limitations to the findings of this systematic review 2 . The overall outcome event rates were low, resulting in wide CIs and limited precision, though heterogeneity was low for all reported outcomes.…”

“…If DVT is not appropriately managed, the thrombus may progress or dislodge leading to pulmonary embolism (PE). DVT was traditionally treated with heparin and vitamin K antagonists (VKAs) 2–4 . However, oral direct thrombin inhibitors (DTIs) and oral factor Xa inhibitors, broadly known as direct oral anticoagulants (DOACs), demonstrate several characteristics that may be favorable to heparin and VKAs.…”

“…This updated Cochrane review published in 2023 included RCTs of participants with confirmed DVT allocated to treatment with a DOAC or conventional anticoagulation 2 . They did not include studies evaluating these treatments by other routes, trials not using conventional treatment with heparin and/or VKAs as the comparison, and trials with treatment less than 3 months.…”

“…The systematic review included 21 trials ( n = 30,895 participants) 2 . Three studies investigated DTIs (two dabigatran and one ximelagatran), 17 studies investigated factor Xa inhibitors (eight rivaroxaban, five apixaban, and four edoxaban), and one trial with three arms investigated both a DTI (dabigatran) and a factor Xa inhibitor (rivaroxaban).…”

“…Deep vein thrombosis (DVT) has an incidence of approximately five per 10,000 annually. [1][2][3] If DVT is not appropriately managed, the thrombus may progress or dislodge leading to pulmonary embolism (PE). DVT was traditionally treated with heparin and vitamin K antagonists (VKAs).…”