Current Opinion on the use of Direct Oral Anticoagulants for the Prophylaxis of Venous Thromboembolism among Medical Inpatients.
Jane J LeeSahar Memar MontazerinFahimehalsadat ShojaeiGerald ChiPublished in: Therapeutics and clinical risk management (2021)
Venous thromboembolism (VTE) is a known cause of morbidity and mortality, especially among acutely ill medical patients. Although VTE prophylaxis is part of post-discharge clinical care in surgical patients, there is controversy regarding its use in acutely ill medical patients and the current guideline statements suggest against its routine use. Recent clinical trials (APEX, MAGELLAN and MARINER) compared the safety and efficacy of direct oral anticoagulants (including betrixaban and rivaroxaban) with the standard of the care, enoxaparin, to identify the risk-benefit tradeoff. In this review, we summarized the key findings from these trials and substudies and recent updates in society guidelines regarding VTE prevention. In addition, we discussed the potential barriers, cost-effectiveness, and COVID-19 with respect to the implementation of extended-duration or post-discharge usage of direct oral anticoagulants.
Keyphrases
- venous thromboembolism
- direct oral anticoagulants
- healthcare
- end stage renal disease
- clinical trial
- ejection fraction
- newly diagnosed
- prognostic factors
- peritoneal dialysis
- palliative care
- quality improvement
- sars cov
- primary care
- atrial fibrillation
- coronavirus disease
- clinical practice
- randomized controlled trial
- patient reported outcomes
- study protocol
- pulmonary embolism
- health insurance
- affordable care act
- chronic pain
- open label