Noninferiority of reduced- versus full-dose anticoagulants can’t be confirmed in sufferers with venous thromboembolism who want prolonged anticoagulation, based on a examine to be introduced on the annual assembly of the American Society of Hematology, held from Dec. 7 to 10 in San Diego.
Francis Couturaud, M.D., Ph.D., from the College of Brest in France, and colleagues carried out a multicenter, potential, randomized trial evaluating prolonged anticoagulation with reduced-dose versus full-dose direct oral anticoagulants in sufferers with venous thromboembolism at excessive danger for recurrence, who have been initially handled for six to 24 months.
The researchers discovered that recurrent venous thromboembolism occurred in 19 of 1,383 sufferers within the reduced-dose group versus 15 of 1,385 within the full-dose group throughout the 36-month median follow-up (five-year cumulative incidence, 2.2 versus 1.8%; hazard ratio, 1.32; 95% confidence interval, 0.67 to 2.60; P = 0.23 for noninferiority). Clinically related bleeding occurred in 96 sufferers within the reduced-dose group and 154 within the full-dose group (five-year cumulative incidence, 9.9 versus 15.2%).
The composite final result of recurrent venous thromboembolism and clinically related bleeding occurred in 113 and 166 sufferers within the reduced- and full-dose teams, respectively (five-year cumulative incidence, 11.8 versus 16.5%). All-cause loss of life occurred in 4.3 and 6.1% of sufferers within the reduced- and full-dose teams, respectively.
“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.
A number of authors disclosed ties to the pharmaceutical business.
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Lowered-dose anticoagulants not noninferior for recurrent venous thromboembolism (2024, December 6)
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