Key result
DOACs linked to ~62% lower risk of second recurrent VTE vs. warfarin without increased bleeding.
Why the study?
The comparative effectiveness and safety of oral anticoagulant therapies to prevent a second recurrent venous thromboembolism remained undetermined.
Does direct oral anticoagulant therapy reduce the risk of a second recurrent VTE compared to warfarin in patients with a recurrent VTE?
Cohort (n=1,459)
Does direct oral anticoagulant therapy reduce the risk of a second recurrent VTE compared to warfarin in patients with a recurrent VTE?
DOACs may be a more effective and similarly safe alternative to warfarin for preventing a second recurrence of VTE in patients who have already experienced a recurrent event.
The comparative effectiveness and safety of oral anticoagulant therapies to prevent a second recurrent venous thromboembolism (VTE) remains undetermined. We aimed to compare the benefits and harms of direct oral anticoagulant (DOAC) and warfarin therapies in preventing second recurrent VTE and major bleeding events among patients with a recurrent VTE episode following anticoagulation therapy for incident VTE. A retrospective cohort analysis of two large national insurance claims databases was conducted for patients with two episodes of VTE. Cox proportional hazards models were used after inverse probability treatment weighting to compare risks of second recurrent VTE and major bleeding events. Compared with warfarin, DOAC therapy was associated with significantly decreased risk of second recurrent VTE with no significant difference in risk of major bleeding events. Our findings suggest that, compared with warfarin, DOACs may reduce risk of second VTE recurrence among patients who have experienced one recurrence.
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Kang et al. (2023) conducted a cohort in Recurrent venous thromboembolism (n=1,459). Direct oral anticoagulants (apixaban and rivaroxaban) vs. Warfarin was evaluated on Time to second recurrent VTE (HR 0.38, 95% CI 0.18-0.77, p=0.01). Compared with warfarin, DOAC therapy significantly reduced the risk of second recurrent VTE (HR 0.38, 95% CI 0.18-0.77, p=0.01) without increasing the risk of major bleeding events.
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