Most Treatments for Acute VTE Appear Safe, Effective
Analysis of studies shows almost all strategies have similar outcomes
WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- Almost all the various treatment options for acute venous thromboembolism are equally safe and effective, according to research published in the Sept. 17 issue of the Journal of the American Medical Association.
In exploring the safety and effectiveness of treatments for deep vein thrombosis or pulmonary embolism, Canadian researchers analyzed outcomes associated with eight anticoagulation options, including unfractionated heparin, low-molecular-weight heparin (LMWH), and fondaparinux in combination with vitamin K antagonists. The investigators also examined LMWH with dabigatran (Pradaxa), edoxaban, rivaroxaban (Xarelto), apixaban (Eliquis), as well as LMWH alone.
After examining nearly 50 randomized studies, the researchers found that unfractionated heparin combined with vitamin K antagonist was associated with a higher percentage of recurrent acute venous thromboembolism over the course of three months than the LMWH-vitamin K antagonist combination. Meanwhile, bleeding risk was lowest with Xarelto and Eliquis compared with LMWH and vitamin K antagonist. The study showed that during three months of treatment, 0.49 percent of patients taking Xarelto had a major bleeding event. The same was true for 0.28 percent of those taking Eliquis. In contrast, 0.89 percent of those taking the LMWH-vitamin K antagonist combination experienced a major bleeding event. All other treatment options had bleeding risks similar to LMWH with vitamin K antagonist.
"To our knowledge, this network meta-analysis is the largest review, including nearly 45,000 patients, assessing the clinical outcomes and safety associated with different anticoagulation strategies for the treatment of acute venous thromboembolism," the study authors said in a journal news release.