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COMPARATIVE EFFICACY AND SAFETY OF NEW ORAL ANTICOAGULANTS VERSUS WARFARIN FOR LONG-TERM TREATMENT OF VENOUS THROMBOEMBOLISM: A META-ANALYSIS
A2094 JACC April 1, 2014 Volume 63, Issue 12
Vascular Medicine Comparative Efficacy and Safety of New Oral Anticoagulants versus Warfarin for LongTerm Treatment of Venous Thromboembolism: A Meta-Analysis Poster Contributions Hall C Sunday, March 30, 2014, 9:45 a.m.-10:30 a.m.
Session Title: Vascular Medicine: Emerging Topics from a Rapidly Changing Landscape Abstract Category: 33. Vascular Medicine: Venous Disease Presentation Number: 1177-74 Authors: Ajay Vallakati, Tilak Pasala, Sanjay Gandhi, Metrohealth Medical Center, Cleveland, OH, USA Introduction: Whether, new oral anticoagulants (NOACs) are alternative to warfarin for extended treatment of venous thromboembolism (VTE) is not clear. We performed a meta-analysis of all randomized controlled trials (RCTs) to assess the safety and efficacy of NOACs for long-term treatment of VTE. Methods: We searched PubMed, Cochrane library and Embase for RCTs comparing NOACs (dabigatran, apixaban, rivaroxaban, and edoxaban) with placebo or warfarin for long-term treatment of VTE. Outcomes studied were recurrent VTE or VTE-related death and major or clinically relevant bleeding (MB). Random effects model was used for statistical analyses. Results: We identified 5 RCTs (n=16117) which compared NOACs (n=8484) with either placebo (n=2085) or warfarin (n=5548). NOACs significantly reduced the risk of VTE or VTE-related death when compared to placebo/ warfarin (OR: 0.33; 95% CI, 0.13 -0.87). However, subgroup analysis did not reveal any significant difference between NOACs and warfarin (OR: 1.03; 95% CI, 0.60 -1.77). Compared to placebo, NOACs increased the risk of bleeding (OR: 2.69; 95% CI, 1.26 -5.75). However, there was a trend towards decreased MB when compared to warfarin (OR: 0.66; 0.43 - 1.01). Conclusions: NOACs are effective for the long term treatment of VTE with reduced risk of VTE or VTE related deaths compared with placebo but similar efficacy to warfarin.
Vascular Medicine Comparative Efficacy and Safety of New Oral Anticoagulants versus Warfarin for LongTerm Treatment of Venous Thromboembolism: A Meta-Analysis Poster Contributions Hall C Sunday, March 30, 2014, 9:45 a.m.-10:30 a.m.
Session Title: Vascular Medicine: Emerging Topics from a Rapidly Changing Landscape Abstract Category: 33. Vascular Medicine: Venous Disease Presentation Number: 1177-74 Authors: Ajay Vallakati, Tilak Pasala, Sanjay Gandhi, Metrohealth Medical Center, Cleveland, OH, USA Introduction: Whether, new oral anticoagulants (NOACs) are alternative to warfarin for extended treatment of venous thromboembolism (VTE) is not clear. We performed a meta-analysis of all randomized controlled trials (RCTs) to assess the safety and efficacy of NOACs for long-term treatment of VTE. Methods: We searched PubMed, Cochrane library and Embase for RCTs comparing NOACs (dabigatran, apixaban, rivaroxaban, and edoxaban) with placebo or warfarin for long-term treatment of VTE. Outcomes studied were recurrent VTE or VTE-related death and major or clinically relevant bleeding (MB). Random effects model was used for statistical analyses. Results: We identified 5 RCTs (n=16117) which compared NOACs (n=8484) with either placebo (n=2085) or warfarin (n=5548). NOACs significantly reduced the risk of VTE or VTE-related death when compared to placebo/ warfarin (OR: 0.33; 95% CI, 0.13 -0.87). However, subgroup analysis did not reveal any significant difference between NOACs and warfarin (OR: 1.03; 95% CI, 0.60 -1.77). Compared to placebo, NOACs increased the risk of bleeding (OR: 2.69; 95% CI, 1.26 -5.75). However, there was a trend towards decreased MB when compared to warfarin (OR: 0.66; 0.43 - 1.01). Conclusions: NOACs are effective for the long term treatment of VTE with reduced risk of VTE or VTE related deaths compared with placebo but similar efficacy to warfarin.