Generic placeholder image

Current Pharmaceutical Design

Editor-in-Chief

ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

Systematic Review Article

Non-Vitamin K Antagonist Oral Anticoagulants in Pulmonary Embolism: An Overview of Systematic Reviews

Author(s): Ioannis Doundoulakis, Christina Antza, Haralambos Karvounis and George Giannakoulas*

Volume 26, Issue 23, 2020

Page: [2686 - 2691] Pages: 6

DOI: 10.2174/1381612826666200506114450

Price: $65

Abstract

Background: Anticoagulation in patients with pulmonary embolism.

Objective: To identify how non-vitamin K antagonist oral anticoagulants are associated with multiple outcomes in patients with pulmonary embolism.

Methods: We performed a systematic search of systematic reviews via multiple electronic databases from inception to August 19th, 2019, without language restriction. Two authors independently extracted data and assessed the methodological quality of the included systematic reviews using the ROBIS tool.

Results: We found twelve systematic reviews. Eleven SRs collected their data from randomized clinical trials and one from observational studies. All the included studies were published between 2014 and 2019 in English. The methodological quality of the 12 systematic reviews was low to high. None of the systematic reviews, which are included in our overview of systematic reviews, has evaluated the overall quality of evidence outcome using the Grading of Recommendations Assessments, Development and Evaluation (GRADE) approach.

Conclusion: This is the first effort to summarize evidence about non-vitamin K antagonist oral anticoagulants in an overview of systematic reviews focusing exclusively on patients with pulmonary embolism. The evidence suggests that the non-vitamin K antagonist oral anticoagulants seem to be more effective and safer than a dualdrug approach with LMWH- VKA.

Keywords: Pulmonary embolism, anticoagulants, systematic review, non-vitamin K antagonist oral anticoagulants, ROBIS tool, dual-drug.

[1]
Lefebvre P, Laliberté F, Nutescu EA, et al. All-cause and potentially disease-related health care costs associated with venous thromboembolism in commercial, Medicare, and Medicaid beneficiaries. J Manag Care Pharm 2012; 18(5): 363-74.
[http://dx.doi.org/10.18553/jmcp.2012.18.5.363] [PMID: 22663169]
[2]
Schulman S, Kakkar AK, Goldhaber SZ, et al. RE-COVER II Trial Investigators. Treatment of acute venous thromboembolism with dabigatran or warfarin and pooled analysis. Circulation 2014; 129(7): 764-72.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.113.004450] [PMID: 24344086]
[3]
Büller HR, Décousus H, Grosso MA, et al. Hokusai-VTE Investigators. Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism. N Engl J Med 2013; 369(15): 1406-15.
[http://dx.doi.org/10.1056/NEJMoa1306638] [PMID: 23991658]
[4]
van der Hulle T, Kooiman J, den Exter PL, Dekkers OM, Klok FA, Huisman MV. Effectiveness and safety of novel oral anticoagulants as compared with vitamin K antagonists in the treatment of acute symptomatic venous thromboembolism: a systematic review and meta-analysis. J Thromb Haemost 2014; 12(3): 320-8.
[http://dx.doi.org/10.1111/jth.12485] [PMID: 24330006]
[5]
Schulman S, Kearon C, Kakkar AK, et al. RE-COVER Study Group. Dabigatran versus warfarin in the treatment of acute venous thromboembolism. N Engl J Med 2009; 361(24): 2342-52.
[http://dx.doi.org/10.1056/NEJMoa0906598] [PMID: 19966341]
[6]
Bauersachs R, Berkowitz SD, Brenner B, et al. EINSTEIN Investigators. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med 2010; 363(26): 2499-510.
[http://dx.doi.org/10.1056/NEJMoa1007903] [PMID: 21128814]
[7]
Agnelli G, Buller HR, Cohen A, et al. AMPLIFY Investigators. Oral apixaban for the treatment of acute venous thromboembolism. N Engl J Med 2013; 369(9): 799-808.
[http://dx.doi.org/10.1056/NEJMoa1302507] [PMID: 23808982]
[8]
Büller HR, Prins MH, Lensin AW, et al. EINSTEIN–PE Investigators. Oral rivaroxaban for the treatment of symptomatic pulmonary embolism. N Engl J Med 2012; 366(14): 1287-97.
[http://dx.doi.org/10.1056/NEJMoa1113572] [PMID: 22449293]
[9]
Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). Eur Respir J 2019; 54(3): 2019.
[http://dx.doi.org/10.1183/13993003.01647-2019] [PMID: 31473594]
[10]
Bougioukas KI, Liakos A, Tsapas A, Ntzani E, Haidich AB. Preferred reporting items for overviews of systematic reviews including harms checklist: a pilot tool to be used for balanced reporting of benefits and harms. J Clin Epidemiol 2018; 93: 9-24.
[http://dx.doi.org/10.1016/j.jclinepi.2017.10.002] [PMID: 29037888]
[11]
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 2009; 62(10): e1-e34.
[http://dx.doi.org/10.1016/j.jclinepi.2009.06.006] [PMID: 19631507]
[12]
Whiting P, Savović J, Higgins JP, et al. ROBIS group. ROBIS: A new tool to assess risk of bias in systematic reviews was developed. J Clin Epidemiol 2016; 69: 225-34.
[http://dx.doi.org/10.1016/j.jclinepi.2015.06.005] [PMID: 26092286]
[13]
Dentali F, Di Minno MN, Gianni M, Ambrosino P, Squizzato A, Ageno W. Non-vitamin K oral anticoagulants in patients with pulmonary embolism: a systematic review and meta-analysis of the literature. Intern Emerg Med 2015; 10(4): 507-14.
[http://dx.doi.org/10.1007/s11739-015-1249-x] [PMID: 25982918]
[14]
Gómez-Outes A, Terleira-Fernández AI, Lecumberri R, Suárez-Gea ML, Vargas-Castrillón E. Direct oral anticoagulants in the treatment of acute venous thromboembolism: a systematic review and meta-analysis. Thromb Res 2014; 134(4): 774-82.
[http://dx.doi.org/10.1016/j.thromres.2014.06.020] [PMID: 25037495]
[15]
Hong Y, Mansour S, Alotaibi G, Wu C, McMurtry MS. Effect of anticoagulants on admission rates and length of hospital stay for acute venous thromboembolism: A systematic review of randomized control trials. Crit Rev Oncol Hematol 2018; 125: 12-8.
[http://dx.doi.org/10.1016/j.critrevonc.2018.02.010] [PMID: 29650271]
[16]
Kakkos SK, Kirkilesis GI, Tsolakis IA. Efficacy and safety of the new oral anticoagulants dabigatran, rivaroxaban, apixaban, and edoxaban in the treatment and secondary prevention of venous thromboembolism: a systematic review and meta-analysis of phase III trials European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 2014; 48(5): 565-75.
[17]
Kirkilesis GI, Kakkos SK, Tsolakis IA. A Systematic Review and Meta-Analysis of the Efficacy and Safety of Anticoagulation in the Treatment of Venous Thromboembolism in Patients with Cancer. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery 2019; 57(5): 685-701.
[18]
Kohn CG, Fermann GJ, Peacock WF, et al. Association between rivaroxaban use and length of hospital stay, treatment costs and early outcomes in patients with pulmonary embolism: a systematic review of real-world studies. Curr Med Res Opin 2017; 33(9): 1697-703.
[http://dx.doi.org/10.1080/03007995.2017.1349659] [PMID: 28665208]
[19]
Mantha S, Ansell J. Indirect comparison of dabigatran, rivaroxaban, apixaban and edoxaban for the treatment of acute venous thromboembolism. J Thromb Thrombolysis 2015; 39(2): 155-65.
[http://dx.doi.org/10.1007/s11239-014-1102-5] [PMID: 24989022]
[20]
Posch F, Königsbrügge O, Zielinski C, Pabinger I, Ay C. Treatment of venous thromboembolism in patients with cancer: A network meta-analysis comparing efficacy and safety of anticoagulants. Thromb Res 2015; 136(3): 582-9.
[http://dx.doi.org/10.1016/j.thromres.2015.07.011] [PMID: 26210891]
[21]
Robertson L, Kesteven P, McCaslin JE. Oral direct thrombin inhibitors or oral factor Xa inhibitors for the treatment of pulmonary embolism. Cochrane Database of Systematic Reviews 2015; (12):
[http://dx.doi.org/10.1002/14651858.CD010957.pub2]
[22]
van Es N, Coppens M, Schulman S, Middeldorp S, Büller HR. Direct oral anticoagulants compared with vitamin K antagonists for acute venous thromboembolism: evidence from phase 3 trials. Blood 2014; 124(12): 1968-75.
[http://dx.doi.org/10.1182/blood-2014-04-571232] [PMID: 24963045]
[23]
Vedovati MC, Becattini C, Germini F, Agnelli G. Efficacy and safety of direct oral anticoagulants after pulmonary embolism: a meta-analysis. Int J Cardiol 2014; 177(2): 601-3.
[http://dx.doi.org/10.1016/j.ijcard.2014.08.136] [PMID: 25217215]
[24]
Schulman S, Kearon C, Kakkar AK, et al. RE-MEDY Trial Investigators; RE-SONATE Trial Investigators.. Extended use of dabigatran, warfarin, or placebo in venous thromboembolism. N Engl J Med 2013; 368(8): 709-18.
[http://dx.doi.org/10.1056/NEJMoa1113697] [PMID: 23425163]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy