Efficacy and safety of the new oral anticoagulants in the treatment of venous thromboembolic complications: meta-analysis

• Published in: Rat͡s︡ionalʹnai͡a︡ farmakoterapii͡a︡ v kardiologii Vol. 12; no. 6; pp. 31 - 39
• Main Authors: V. I. Petrov, O. V. Shatalova, V. S. Gorbatenko, O. N. Smuseva, A. S. Maslakov
• Format: Journal Article
• Language: English
• Published: Столичная издательская компания 01.01.2017
• Subjects: meta-analysis; new oral anticoagulants; randomized clinical trials; venous thromboembolism
• ISSN: 1819-6446; 2225-3653

Aim. Analysis of the efficacy and safety of the new oral anticoagulants (NOACs) in the management of venous thromboembolism (VTE).Material and methods. This meta-analysis of randomized controlled trials (RCTs) was made in accordance with the instructions “Preferred reporting items for systematic reviews and meta-analyses (PRISMA)”.Results. The meta-analysis included 5 RCTs. NOACs were as effective as vitamin K antagonists (VKAs) in preventing recurrent symptomatic VTE (RR=0.93; 95% CI 0.77-1.12; p=0.44). The incidence of recurrent thrombosis (RR=0.82; 95% CI 0.63-1.08; p=0.16) and deep vein thrombosis ± fatal or nonfatal pulmonary embolism (RR=1.06; 95% CI 0.81-1.40; p=0.66) was comparable in the groups of comparison. Meta-analysis of the safety of the NOACs suggested significant reduction of risk of major bleeding as compared with standard therapy (RR=0.54; 95% CI 0.42-0.69; р<0.00001). The incidence of all types of bleeding was significantly lower with NOACs (RR=0.70; 95% CI 0.51-0.95; p=0.02). All-cause mortality rate was comparable between the groups (RR=0.93; 95% CI 0.76-1.13; p=0.46).Conclusions. NOACs are as effective as the standard therapy, at that they are much safer in VTE treatment.