What is the clinical evidence from this study?

Study design: Cohort. Population: Venous thromboembolism (DVT or PE) (n=18147). Intervention: Body weight >120 kg vs. Body weight <120 kg. Primary outcome: Six-month readmission rates for VTE recurrence (p=0.08).

What does this research mean for the field?

In patients with venous thromboembolism treated with direct oral anticoagulants, six-month recurrence rates do not significantly differ between patients weighing over 120 kg and those weighing under 120 kg. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

August 25, 2020CureusOpen Access

The Use of Direct Oral Anticoagulants in the Management of Venous Thromboembolism in Patients With Obesity

Q: What are the key findings of this study?

In patients with venous thromboembolism treated with direct oral anticoagulants, six-month VTE recurrence rates were similar between those weighing >120 kg (36%) and those weighing <120 kg (34%).

Q: What does this research mean for the field?

In patients with venous thromboembolism treated with direct oral anticoagulants, six-month recurrence rates do not significantly differ between patients weighing over 120 kg and those weighing under 120 kg. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

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Key result

DOACs show similar six-month VTE recurrence rates in patients weighing over versus under 120 kg.

P=0.08
n=18,147

Why the study?

DOACs are currently not recommended as first-line agents in obese patients, prompting an assessment of VTE recurrence rates in this population.

Does DOAC therapy prevent VTE recurrence equally in patients weighing >120 kg compared to those weighing <120 kg?

Study Design

Type

Cohort (n=18,147)

Multicenter

Yes

Structured PICO

Does DOAC therapy prevent VTE recurrence equally in patients weighing >120 kg compared to those weighing <120 kg?

Population

18,147 patients with acute deep venous thrombosis or pulmonary embolism treated with direct oral anticoagulants, followed for 6 months to compare VTE recurrence between those weighing >120 kg and <120 kg.

Exposure

Direct oral anticoagulants (DOACs) in patients weighing >120 kg

Comparator

Direct oral anticoagulants (DOACs) in patients weighing <120 kg

Outcome

Six-month readmission rates for VTE recurrencehard clinical

Main Result

Absolute Event Rate: 36% vs 34%

p-value: p=0.08

DOACs demonstrate similar 6-month VTE recurrence rates in patients weighing >120 kg compared to those <120 kg, challenging current recommendations against their use in severe obesity.

Limitations

Retrospective design limits the ability to draw powerful conclusions.
Only 13% of the patient cohort were in the group with body weight >120 kg.
Lack of secondary outcomes or other patient-clinical or laboratory characteristics due to database limitations.
Higher proportion of females in the group with body weight <120 kg.

Discussion

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Implication

Hypothesis-generating for DOAC use in severe obesity; prospective trials needed before clinical adoption.

Cite This Study

Younis et al. (2020) conducted a cohort in Venous thromboembolism (DVT or PE) (n=18,147). Body weight >120 kg vs. Body weight <120 kg was evaluated on Six-month readmission rates for VTE recurrence (p=0.08). In patients with venous thromboembolism treated with direct oral anticoagulants, six-month VTE recurrence rates were similar between those weighing >120 kg (36%) and those weighing <120 kg (34%).

synapsesocial.com/papers/6aa7e5f0bfbaf8fff0574790 https://doi.org/10.7759/cureus.10006

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The Use of Direct Oral Anticoagulants in the Management of Venous Thromboembolism in Patients With Obesity

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

The Use of Direct Oral Anticoagulants in the Management of Venous Thromboembolism in Patients With Obesity

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider