The provided text contains only editorial board information and lacks any clinical findings or results.
Meta-Analysis
Do reduced-dose DOACs prevent recurrent VTE with less bleeding compared to standard-dose DOACs in patients requiring extended VTE treatment?
For extended VTE treatment, reduced-dose DOACs provide similar efficacy for preventing recurrent VTE while significantly reducing the risk of major and clinically relevant non-major bleeding compared to standard-dose DOACs.
Introduction:Reduced-dose direct oral anticoagulants (DOACs) may provide similar efficacy with less bleeding than standard-dose for extended venous thromboembolism (VTE) treatment. It is unclear whether standard-dose are preferable in certain subgroups. Methods:We systematically searched MEDLINE, EMBASE, EMCARE, and CENTRAL for randomized trials comparing reduced- with standard-dose DOACs for extended VTE treatment.(INPLASY202550061) Outcomes included recurrent VTE, major bleeding, clinically relevant non-major bleeding (CRNMB), and mortality. Results: Five trials (8,781 patients) were included. Reduced-dose DOACs (apixaban 2.5mg twice daily or rivaroxaban 10mg once daily, n=4,395), compared to standard-dose (apixaban 5mg twice daily or rivaroxaban 20mg once daily, n=4,386), resulted in similar rates of recurrent VTE (1.66% vs 1.78%; risk ratio RR 0.94, 95% confidence interval CI 0.68–1.29). Major bleeding was less frequent with reduced-dose (1.16% vs 1.96%; RR 0.62, 95% CI 0.42–0.92), as was CRNMB (5.16% vs 7.00%; RR 0.75, 95% CI 0.63–0.88). Mortality rates were comparable (4.91% vs 5.81%; RR 0.86, 95% CI 0.63–1.17). These results held for high-risk subgroups, including patients with recurrent VTE or active cancer, except that reduced-dose DOACs appeared to lower recurrent VTE risk in males but increase risk in females (p=0.04). Risk of bias was rated “low” in four studies and “some concerns” in one study. Certainty of evidence was moderate for three outcomes and low for one outcome. Conclusion:For extended VTE treatment, reduced-dose DOACs have a similar risk of recurrent VTE and a lower risk of major and CRNMB compared to standard-dose, including in high-risk patients. A potential interaction with sex warrants further investigation
Cheung et al. (Fri,) conducted a meta-analysis in venous thromboembolism. Reduced dose direct oral anticoagulant vs. Standard dose direct oral anticoagulant was evaluated. The provided text contains only editorial board information and lacks any clinical findings or results.