Extended Anticoagulation for VTE: A Systematic Review and Meta-Analysis.

@article{Mai2019ExtendedAF,
  title={Extended Anticoagulation for VTE: A Systematic Review and Meta-Analysis.},
  author={Vicky Mai and Charles-Antoine Guay and Laurie Perreault and S{\'e}bastien Bonnet and Laurent Bertoletti and Yves Lacasse and Sabine Jardel and J C Lega and Steeve Provencher},
  journal={Chest},
  year={2019},
  volume={155 6},
  pages={
          1199-1216
        }
}
DOAC compared to LMWH in the treatment of cancer related-venous thromboembolism: a systematic review and meta-analysis
TLDR
DOAC were non-inferior to LMWH in preventing CA-VTE recurrence, but were associated with an increased risk of MB and CRNMB, and the risk/benefit ratio for specific populations.
Individualised Risk Assessments for Recurrent Venous Thromboembolism: New Frontiers in the Era of Direct Oral Anticoagulants
TLDR
There is a need for an individualised, targeted approach for assessing the risk of VTE recurrence, especially in those patients in whom the balance between benefit and risk of long-term anticoagulation is not clear.
Comparison of Bleeding Risk Scores in Elderly Patients Receiving Extended Anticoagulation with Vitamin K Antagonists for Venous Thromboembolism.
TLDR
The predictive performance of most clinical bleeding risk scores does not appear to be sufficiently high to identify elderly patients with VTE who are at high risk of bleeding and who may therefore not be suitable candidates for extended anticoagulation.
Treatment for Pulmonary Embolism: Anticoagulation Selection and Duration
TLDR
Select patient populations at high risk for clinical failure or hemorrhagic events, including morbidly obese, frail, elderly, or severe kidney dysfunction require further investigation into the optimal anticoagulant therapy that balances safety and effectiveness.
Long-term treatment of venous thromboembolism.
TLDR
After PE, patients should have clinical surveillance for chronic thromboembolic pulmonary hypertension, with ventilation-perfusion scanning and echocardiography being the initial diagnostic tests if CTEPH is a concern.
Diagnosis and Treatment of Lower Extremity Venous Thromboembolism: A Review.
TLDR
Direct oral anticoagulants are noninferior to warfarin with regard to efficacy and are associated with lower rates of bleeding, but costs limit use for some patients.
Extending anticoagulation treatment for unprovoked venous thromboembolism
TLDR
Two recent systematic reviews have addressed uncertainties about extending anticoagulation beyond the usually recommended periods in patients with unprovoked venous thromboembolism, and the rate of recurrent VTE has been studied in a recent BMJ systematic review.
...
...

References

SHOWING 1-10 OF 49 REFERENCES
The impact of bleeding complications in patients receiving target-specific oral anticoagulants: a systematic review and meta-analysis.
TLDR
A systematic review and meta-analysis of phase-3 randomized controlled trials to assess the bleeding side effects of TSOACs compared with VKAs in patients with venous thromboembolism or atrial fibrillation found they are associated with less major bleeding, fatal bleeding, intracranial bleeding, clinically relevant nonmajor bleeding, and total bleeding.
Direct oral anticoagulants compared with vitamin K antagonists for acute venous thromboembolism: evidence from phase 3 trials.
TLDR
The efficacy and safety of DOACs were consistent in patients with pulmonary embolism, deep venous thrombosis, a body weight ≥100 kg, moderate renal insufficiency, an age ≥75 years, and cancer.
Efficacy and safety outcomes of oral anticoagulants and antiplatelet drugs in the secondary prevention of venous thromboembolism: systematic review and network meta-analysis
TLDR
All oral anticoagulants and antiplatelet agents investigated in this analysis were associated with a reduced recurrence of venous thromboembolism compared with placebo or observation, although acetylsalicylic acid was associated with the lowest risk reduction.
Clinical and safety outcomes associated with treatment of acute venous thromboembolism: a systematic review and meta-analysis.
TLDR
Findings suggest that the UFH-vitamin K antagonist combination is associated with the least effective strategy and that rivaroxaban and apixaban may be associatedwith the lowest risk for bleeding.
Apixaban for extended treatment of venous thromboembolism.
TLDR
Extended anticoagulation with apixaban at either a treatment dose (5 mg) or a thromboprophylactic dose (2.5mg) reduced the risk of recurrent venous thromboembolism without increasing the rate of major bleeding.
Comparative risk of gastrointestinal bleeding with dabigatran, rivaroxaban, and warfarin: population based cohort study
TLDR
The risk of gastrointestinal bleeding related to novel oral anticoagulants was similar to that for warfarin, and caution should be used when prescribing novel oral anti-cancer drugs to older people, particularly those over 75 years of age.
...
...