Noninferiority of reduced-dose anticoagulants could not be proven in patients with VTE who need extended anticoagulation<\/p>\n<\/h3>\n
By Elana Gotkine HealthDay Reporter<\/b>
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FRIDAY, Dec. 6, 2024 (HealthDay News) — Noninferiority of reduced- versus full-dose anticoagulants cannot be proven in patients with venous thromboembolism who need extended anticoagulation, according to a study to be presented at the annual meeting of the American Society of Hematology, held from Dec. 7 to 10 in San Diego.<\/p>\n
Francis Couturaud, M.D., Ph.D., from the University of Brest in France, and colleagues conducted a multicenter, prospective, randomized trial comparing extended anticoagulation with reduced-dose versus full-dose direct oral anticoagulants in patients with venous thromboembolism at high risk for recurrence, who were initially treated for six to 24 months.<\/p>\n
The researchers found that recurrent venous thromboembolism occurred in 19 of 1,383 patients in the reduced-dose group versus 15 of 1,385 in the full-dose group during the 36-month median follow-up (five-year cumulative incidence, 2.2 versus 1.8 percent; hazard ratio, 1.32; 95 percent confidence interval, 0.67 to 2.60; P = 0.23 for noninferiority). Clinically relevant bleeding occurred in 96 patients in the reduced-dose group and 154 in the full-dose group (five-year cumulative incidence, 9.9 versus 15.2 percent). The composite outcome of recurrent venous thromboembolism and clinically relevant bleeding occurred in 113 and 166 patients in the reduced- and full-dose groups, respectively (five-year cumulative incidence, 11.8 versus 16.5 percent). All-cause death occurred in 4.3 and 6.1 percent of patients in the reduced- and full-dose groups, respectively.<\/p>\n
“The noninferiority of a reduced-dose versus a full-dose of direct anticoagulants to prevent recurrent venous thromboembolism could not be proven,” the authors write.<\/p>\n
Several authors disclosed ties to the pharmaceutical industry.<\/p>\n