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Erschienen in:

26.02.2024

Retrospective, multicenter analysis of the safety and effectiveness of direct oral anticoagulants for the treatment of venous thromboembolism in obesity

verfasst von: Jeffrey D. Sperry, Aletha Loeb, Melissa J. Smith, Tessa B. Brighton, Julie A. Ehret, Joli D. Fermo, Morgan E. Gentili, Jason W. Lancaster, Jennifer N. Mazur, Katherine Spezzano, Jennifer A. Szwak

Erschienen in: Journal of Thrombosis and Thrombolysis | Ausgabe 4/2024

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Abstract

Background

Direct oral anticoagulants (DOACs) are the preferred treatment for venous thromboembolism (VTE). However, DOAC use in patients with a BMI greater than 40 kg/m² has not been well studied despite the growing prevalence of obesity, and current literature is often underpowered.

Methods

This multicenter, retrospective, observational study evaluated patients 18 years and older who received DOACs for acute VTE treatment. Patients receiving DOACs for recurrent VTE or for failure of another agent were excluded. The primary efficacy outcome was recurrent VTE and the primary safety outcome was major bleeding within 12 months (or one month after stopping anticoagulation therapy). A propensity score analysis was performed to balance patient characteristics and evaluate the primary endpoints by BMI group. Time-to-event outcomes were analyzed using weighted Kaplan-Meier curves.

Results

There were 165 patients with a BMI of at least 40 kg/m² and 320 patients with a BMI less than 40 kg/m². The majority received apixaban (373, 77%). Recurrent VTE occurred in 5 (3.0%) and 13 (4.1%) of patients in the higher and lower BMI groups, respectively (adjusted OR: 0.66; 95% CI: 0.16–2.69). Major bleeding occurred in 5 (3.0%) and 15 (4.7%) of patients in the higher and lower BMI groups, respectively (adjusted OR: 1.19; 95% CI: 0.36–3.92).

Conclusion

There was no significant difference in VTE recurrence or major bleeding related to BMI among patients treated with DOACs. This study showed that DOACs may be a safe and effective VTE treatment option in patients with obesity.

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Titel: Retrospective, multicenter analysis of the safety and effectiveness of direct oral anticoagulants for the treatment of venous thromboembolism in obesity
verfasst von: Jeffrey D. Sperry
Aletha Loeb
Melissa J. Smith
Tessa B. Brighton
Julie A. Ehret
Joli D. Fermo
Morgan E. Gentili
Jason W. Lancaster
Jennifer N. Mazur
Katherine Spezzano
Jennifer A. Szwak
Publikationsdatum: 26.02.2024
Verlag: Springer US
Erschienen in: Journal of Thrombosis and Thrombolysis / Ausgabe 4/2024
Print ISSN: 0929-5305
Elektronische ISSN: 1573-742X
DOI: https://doi.org/10.1007/s11239-024-02955-6

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Retrospective, multicenter analysis of the safety and effectiveness of direct oral anticoagulants for the treatment of venous thromboembolism in obesity