Obese patients require higher doses or weight-based dosing of anticoagulants for venous thromboembolism prophylaxis and treatment, though high-quality randomized trials are urgently needed to determine optimal regimens.
How should anticoagulants be dosed and monitored for treatment and prophylaxis of thrombosis in obese individuals?
Dosing and monitoring of anticoagulants in obese patients remains challenging due to a lack of detailed studies.
Management of anticoagulation has become a hot topic in the last decade. Health-care professionals are encountering increasing number of patients diagnosed with a thromboembolic episode, probably as a result of heightened awareness. In addition, the recognition that hospital-acquired thrombosis causes substantial mortality has led to an emphasis on appropriate thromboprophylaxis in all patients deemed at risk of thrombosis. However, the use of anticoagulants for both treatment and prophylaxis of thrombosis can pose a challenge in individuals who are obese. There are no detailed studies in this area and as such the dosing and monitoring of anticoagulants in these individuals can be problematic.
Raja et al. (2020) conducted a review in Venous thromboembolism in obese patients. Anticoagulation was evaluated. Obese patients require higher doses or weight-based dosing of anticoagulants for venous thromboembolism prophylaxis and treatment, though high-quality randomized trials are urgently needed to determine optimal regimens.