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December 8, 2025BloodOpen Access

Efficacy and safety of low-dose vs. standard-dose direct oral anticoagulants for secondary prevention of venous thromboembolism: A systematic review and meta-analysis

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Authors

EDEduardo DanGSG.T. Sánchez

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Overview

Meta-analysis reveals reduced-dose DOACs lower major bleeding risk in venous thromboembolism, suggesting a safer treatment approach.

Key Points

  • This meta-analysis assesses the efficacy and safety of low-dose versus standard-dose direct oral anticoagulants for VTE prevention.
  • Conducted a meta-analysis of randomized controlled trials (RCTs)
  • Evaluated reduced-dose apixaban and rivaroxaban against standard doses
  • Analyzed efficacy and safety outcomes including major bleeding and PE
  • Performed subgroup analyses based on age, sex, BMI, eGFR, and thrombophilia
  • Rates of recurrent VTE were similar for reduced and standard doses
  • Reduced-dose regimens significantly decreased major bleeding risk
  • Subgroup analyses indicated lower odds of bleeding in both sexes receiving reduced doses
  • Possible sex-based differences in VTE recurrence were noted

Cite This Study

Dan et al. (2025) studied this question.

synapsesocial.com/papers/69362f6e4fa91c937236e15bhttps://doi.org/10.1182/blood-2025-1351
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