Safety of direct oral anticoagulants in patients with mild to moderate cirrhosis: a systematic review and meta-analysis

Haemostatic alterations and management of haemostasis in patients with cirrhosis

“…133,134 A recent systematic review of 7 studies including 683 patients found no significant difference in major bleeding rates between patients who received DOACs or traditional anticoagulants. 135 However, more recently, experience with DOAC use in patients with Child-Pugh B/C cirrhosis reveals increased bleeding rates in patients with advanced cirrhosis. 136,137 Therefore, caution is required when using DOACs in patients with cirrhosis and further studies are needed.…”

Recommendations from the ICM-VTE: General

“…There is low-quality evidence on safety profile of directoral anticoagulants (DOAC) in CLD patients [1421][1422][1423] . Recent guidelines 1424 recommend the preferential use of DOAC over low-molecular-weight heparin (LMWH) in the setting of VTE prophylaxis in orthopaedic surgery, but questions must be raised about such a recommendation in patients with liver disease who undergo orthopaedic surgery.…”

Coagulopathy and hemostasis management in patients undergoing liver transplantation: Defining a dynamic spectrum across phases of care

“…[ 51 ] Direct oral anticoagulants (DOACs) are emerging as a therapy for anticoagulation, and although data remain limited, clinical studies in patients with compensated cirrhosis support the safety of these agents. [ 52 ]…”

“…[51] Direct oral anticoagulants (DOACs) are emerging as a therapy for anticoagulation, and although data remain limited, clinical studies in patients with compensated cirrhosis support the safety of these agents. [52] Current societal guidelines suggest the use of anticoagulation in patients with cirrhosis with indications for therapy. [1,53] Patients with cirrhosis demonstrate increased risks of thromboembolic disease, with portal vein thrombosis (PVT) occurring in up to 20% of patients.…”