DOAC or Warfarin: Which Is Safer For Patients With VTE?
Direct oral anticoagulant (DOAC) use was not associated with an increased risk of major bleeding or mortality among patients with venous thromboembolism, according to the findings of a recent study.
The study included 59,525 adults with a new diagnosis of venous thromboembolism who had received a prescription for DOAC (n=12,489) or warfarin (n=47,036) within 30 days following diagnosis. Hospital admission or emergency department visit for major bleeding and all-cause mortality within 90 days after initiating DOAC or warfarin treatment were assessed as the main outcomes. In addition, the researchers estimated hazard ratios (HR) to compare outcomes associated with either treatment.
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Over the median 85.2 days of follow-up, 1967 participants (3.3%) experienced a major bleeding event and 1029 (1.7%) participants died.
The risk for major bleeding was similar for both DOAC and warfarin use (pooled HR 0.92), but the overall direction favored DOAC. Likewise, there were no differences in the risk of death between either treatment.
In addition, the researchers found no evidence of heterogeneity across centers, between patients with and without chronic kidney disease, between age groups, or between sexes.
“In this analysis of adults with incident venous thromboembolism, treatment with DOACs, compared with warfarin, was not associated with an increased risk of major bleeding or all-cause mortality in the first 90 days of treatment,” the researchers concluded.
—Melissa Weiss
Reference:
Jun M, Lix LM, Durand M, et al. Comparative safety of direct oral anticoagulants and warfarin in venous thromboembolism: multicentre, population based, observational study [published online October 17, 2017]. BMJ. https://doi.org/10.1136/bmj.j4323.