Key result
Home treatment of low-risk emergency department patients with VTE using apixaban or rivaroxaban resulted in a 30-day recurrent VTE rate of 1.0% (95% CI 0.5-1.7%) and a bleeding rate of 0.8%.
Why the study?
To test whether low-risk emergency department patients with VTE can be safely and effectively treated at home with direct acting oral monotherapy anticoagulation in a real-world pragmatic trial.
Does direct acting oral anticoagulation monotherapy safely and effectively treat low-risk venous thromboembolism in emergency department patients discharged home?
Population
1421 low-risk ED patients with newly diagnosed VTE discharged within 24 hours in the United States
Comparison
Home treatment with apixaban or rivaroxaban monotherapy
Design
Multicenter single-arm pragmatic effectiveness trial
Follow-up
30 days
Authors
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Supports outpatient DOAC management for selected low-risk VTE; hypothesis-generating and should not yet change practice without RCTs.
Does direct acting oral anticoagulation monotherapy safely and effectively treat low-risk venous thromboembolism in emergency department patients discharged home?
Home treatment of low-risk venous thromboembolism patients from the emergency department using direct oral anticoagulant monotherapy is safe and effective, with very low rates of recurrence and major bleeding at 30 days.
Kline et al. (2021) studied Venous Thromboembolism (n=1,421). Direct acting oral anticoagulation (apixaban or rivaroxaban) was evaluated on Image-proven recurrent VTE requiring hospitalization >24 hours at 30 days (95% CI 0.5-1.7). Home treatment of low-risk emergency department patients with VTE using apixaban or rivaroxaban resulted in a 30-day recurrent VTE rate of 1.0% (95% CI 0.5-1.7%) and a bleeding rate of 0.8%.
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