Please login or register to print this page.

Clinical Articles, Lead Article

Meta-analysis confirms less bleeding risk with new oral anticoagulants

When compared with vitamin K antagonists (VKAs) administered to a target INR of 2.0 to 3.0, target-specific oral anticoagulants (TSOACs) are associated with less major bleeding, fatal bleeding, intracranial bleeding, clinically relevant non-major bleeding, and total bleeding, according to a study published recently in Blood.1

TSOACs have previously been found to be at least non-inferior to VKAs with regard to efficacy, but the risk of bleeding with TSOACs remains controversial. Authors led by Professor Mark Crowther (McMaster University, Ontario, Canada) performed a systematic review and meta-analysis of phase-3 randomised controlled trials (RCTs) to assess the bleeding side effects of TSOACs compared with VKAs in patients with venous thromboembolism or atrial fibrillation. They searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials; conference abstracts; and www.clinicaltrials.gov with no language restriction.

Two reviewers independently performed study selection, data extraction, and study quality assessment. 12 RCTs involving 102,607 patients were retrieved. TSOACs were found to significantly reduce the risk of overall major bleeding (relative risk [RR] 0.72, P < .01), fatal bleeding (RR 0.53, P < .01), intracranial bleeding (RR 0.43, P < .01), clinically relevant non-major bleeding (RR 0.78, P < .01), and total bleeding (RR 0.76, P < .01).

Professor Mark Crowther (McMaster University, Ontario, Canada)

Professor Mark Crowther (McMaster University, Ontario, Canada)

There was no significant difference in major gastrointestinal bleeding between TSOACs and VKAs (RR 0.94, P = .62). When compared with VKAs, TSOACs are associated with less major bleeding, fatal bleeding, intracranial bleeding, clinically relevant non-major bleeding, and total bleeding. Additionally, TSOACs do not increase the risk of gastrointestinal bleeding, the authors conclude.

References

1. Chai-Adisaksopha C, Crowther M, Isayama T, Lim W. The impact of bleeding complications in patients receiving target-specific oral anticoagulants: a systematic review and meta-analysis. Blood 2014;124:2450–8. http://dx.doi.org/10.1182/blood-2014-07-590323

Published on: January 29, 2015

Members Area

Log in or Register now.

 For healthcare professionals only
Learning sky

SEARCH THE SITE

RSS FEED

Subscribe to our RSS feed
home

GET EXCLUSIVE UPDATES

Sign up for our regular email newsletters & be the first to know about fresh articles and site updates.

RECENT COMMENTS

    None Found

ENDORSED BY

  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

You are not logged in

You need to be a member to print this page.
Sign up for free membership, or log in.

You are not logged in

You need to be a member to download PDF's.
Sign up for free membership, or log in.