Publication: Comparative effectiveness of oral anticoagulants in venous thromboembolism: GARFIELD-VTE
Issued Date
2020-07-01
Resource Type
ISSN
18792472
00493848
00493848
Other identifier(s)
2-s2.0-85084418855
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Mahidol University
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SCOPUS
Bibliographic Citation
Thrombosis Research. Vol.191, (2020), 103-112
Suggested Citation
Henri Bounameaux, Sylvia Haas, Alfredo E. Farjat, Walter Ageno, Jeffrey I. Weitz, Samuel Z. Goldhaber, Alexander G.G. Turpie, Shinya Goto, Pantep Angchaisuksiri, Joern Dalsgaard Nielsen, Gloria Kayani, Sebastian Schellong, Lorenzo G. Mantovani, Paolo Prandoni, Ajay K. Kakkar Comparative effectiveness of oral anticoagulants in venous thromboembolism: GARFIELD-VTE. Thrombosis Research. Vol.191, (2020), 103-112. doi:10.1016/j.thromres.2020.04.036 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/56231
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Title
Comparative effectiveness of oral anticoagulants in venous thromboembolism: GARFIELD-VTE
Other Contributor(s)
Thrombosis & Atherosclerosis Research Institute
IRCCS Multimedica
McMaster University
Tokai University School of Medicine
UCL
Technical University of Munich
Brigham and Women's Hospital
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Copenhagen University Hospital
Thrombosis Research Institute
University of Milano - Bicocca
Università degli Studi dell'Insubria
Université de Genève
Municipal Hospital Dresden
Arianna Foundation on Anticoagulation
IRCCS Multimedica
McMaster University
Tokai University School of Medicine
UCL
Technical University of Munich
Brigham and Women's Hospital
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Copenhagen University Hospital
Thrombosis Research Institute
University of Milano - Bicocca
Università degli Studi dell'Insubria
Université de Genève
Municipal Hospital Dresden
Arianna Foundation on Anticoagulation
Abstract
© 2020 Elsevier Ltd Introduction: Randomized controlled trials have shown that direct oral anticoagulants (DOACs) are a safe and effective alternative to vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE). However, there are limited post-marketing data describing the effectiveness and safety of the DOACs in the community setting. We aimed to compare the effectiveness of DOACs and VKAs on 12-month outcomes in a real-world VTE patient population. Methods: The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE is an observational study designed to document real-world treatment practices. This intention-to-treat analysis included 7987 VTE patients initiated on either DOACs (N = 4791) or VKAs (N = 3196) with or without pre-treatment with parenteral anticoagulants. Treatment groups were balanced according to baseline characteristics, using overlapping propensity score weights. Results: After adjustment for baseline characteristics, all-cause mortality was significantly lower with DOAC than with VKAs (hazard ratio [HR]: 0.73; 95% confidence interval [CI] 0.56–0.95. Patients receiving VKAs were more likely than those receiving DOACs to die of complications of VTE (4.7% vs 2.7%) or from bleeding (4.2% vs. 1.3%). There was no significant difference in recurrent VTE (HR: 0.91, 95% CI 0.71–1.18), major bleeding (HR 1.03, 95% CI 0.69–1.54), or overall bleeding (HR 0.96, 95% CI 0.81–1.14) with DOACs or VKAs. Conclusions: n this real-world analysis of VTE treatment, DOACs were associated with reduced all-cause mortality compared with VKAs, and similar rates of recurrent VTE and bleeding.