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September 26, 2022Frontiers in MedicineOpen Access

Anticoagulant for treatment and prophylaxis of venous thromboembolism patients with renal dysfunction: A systematic review and network meta-analysis

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Why the study?

The study aimed to compare the efficacy and safety of particular anticoagulant regimens and dosages for venous thromboembolism (VTE) treatment and prophylaxis in patients with renal insufficiency.

Does the choice of anticoagulant affect efficacy and safety outcomes in patients with venous thromboembolism and renal insufficiency?

Comparison

Various anticoagulant regimens and dosages for acute VTE, extension treatment, and prophylaxis

Design

Systematic review and network meta-analysis of RCTs

Authors

GFGuohui FanDWDingyi WangMZMeng Zhang

Discussion

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Overview

Apixaban/rivaroxaban raise death/recurrence risk versus dabigatran in acute VTE with renal insufficiency; extends network comparisons to guide regimen selection.

Structured PICO

Does the choice of anticoagulant affect efficacy and safety outcomes in patients with venous thromboembolism and renal insufficiency?

P
Population
21 RCTs pooling 76,574 participants, including 8,972 (11.7%) patients with renal insufficiency requiring venous thromboembolism (VTE) treatment (acute or extension phase) or prophylaxis.
I
Intervention
Anticoagulants (including dabigatran etexilate, apixaban, rivaroxaban, aspirin, desirudin, enoxaparin) as a class for VTE treatment or prophylaxis.
C
Comparator
Active comparators within the network meta-analysis (e.g., dabigatran etexilate, enoxaparin).
O
Outcome
Efficacy (composite of death, recurrence, or occurrence of VTE) and safety (bleeding).composite

In patients with renal insufficiency, dabigatran etexilate may be more effective than apixaban or rivaroxaban for acute VTE treatment, while aspirin and apixaban show favorable profiles for extension treatment.

Cite This Study

Fan et al. (2022) studied this question.

synapsesocial.com/papers/6a6fecf9febe604dd708bf2ehttps://doi.org/10.3389/fmed.2022.979911
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Efficacy and safety of anticoagulant for treatment and prophylaxis of VTE patients with renal insufficiency: a systemic review and meta-analysis2024 · 6 citations
  2. 2Comparative efficacy and safety of oral anticoagulants for the treatment of venous thromboembolism in the patients with different renal functions: a systematic review, pairwise and network meta-analysis2022 · 14 citations
  3. 3Efficacy and safety of anticoagulants on venous thromboembolism: a systematic review and network meta-analysis of randomized controlled trials2025 · 5 citations
  4. 4Rivaroxaban versus enoxaparin/vitamin K antagonist therapy in patients with venous thromboembolism and renal impairment2014 · 65 citations
  5. 5Comparison of the Non-VKA Oral Anticoagulants Apixaban, Dabigatran, and Rivaroxaban in the Extended Treatment and Prevention of Venous Thromboembolism: Systematic Review and Network Meta-Analysis2016 · 69 citations