Non-vitamin K antagonist oral anticoagulants in venous thromboembolism patients: a meta-analysis of real-world studies.
Non-vitamin K antagonist oral anticoagulants in venous thromboembolism patients: a meta-analysis of real-world studies.
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非维生素 K 拮抗剂口服抗凝药用于静脉血栓栓塞患者：现实世界研究的荟萃分析
DOI：
10.1186/s12872-022-02550-8
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发表时间：
2022-03-14
影响因子：
2.1
通讯作者：
Cui YM
中科院分区：
文献类型：
--
作者：
Liu ZY;Zhang HX;Ma LY;Mu GY;Xie QF;Zhou S;Wang ZN;Wang Z;Hu K;Xiang Q;Cui YM
关于静脉血栓栓塞（VTE）复发和非维生素K拮抗剂口服抗凝剂（NOAC）治疗VTE患者出血事件的真实世界研究报告了相互矛盾的结果。我们的研究旨在为临床实践环境中VTE患者提供不同NOAC的直接比较证据。使用PubMed、Web of Science、EMBASE、Clinical Trials.gov和科克伦图书馆对医学文献进行了检索，检索时间从研究开始到2021年3月22日。在检索到的19，996篇引文中，共分析了来自6项研究的63，144例患者。临床结局包括复发性VTE、死亡和不同的出血事件。校正的风险比（HR）分析表明，阿哌沙班的出血风险显著低于利伐沙班（大出血、小出血和任意出血：HR = 0.61，0.56，0.70; P = 0.008，< 0.0001，0.006），但在复发性VTE事件中无统计学差异（HR = 1.02，95%置信区间（CI）0.71-1.47，p = 0.93）。达比加群与利伐沙班（比值比（OR）= 0.41，95% CI 0.09-1.90，p = 0.25）、阿哌沙班与达比加群（OR 0.64，95% CI 0.15-2.72，p = 0.83）之间的大出血无显著差异。在VTE复发、大出血和复合结局方面，依度沙班与其他NOAC的比较无显著差异。在预防出血事件方面，阿哌沙班的风险低于利伐沙班，但不同NOAC在预防复发性VTE方面的疗效相同。基于真实世界数据的荟萃分析产生的证据可以帮助指导在常规临床实践中选择阿哌沙班和利伐沙班。试验注册：本系统性综述和荟萃分析根据系统性综述和荟萃分析的首选报告项目以及流行病学观察性研究的荟萃分析声明进行和报告，并在PROSPERO注册（CRD 42019140553）。在线版本包含补充材料，可通过10.1186/s12872-022-02550-8获得。
The real-world studies on recurrent venous thromboembolism (VTE) and bleeding events of non-vitamin K antagonist oral anticoagulants (NOACs) in VTE patients have reported conflicting findings. Our study aimed to provide the direct comparison evidence of different NOACs for VTE patients in clinical practice settings. Search of the medical literature was conducted using PubMed, Web of Science, EMBASE, Clinical Trials.gov, and the Cochrane Library from inception to March 22, 2021. Among the 19,996 citations retrieved, a total of 63,144 patients from 6 studies were analyzed. Clinical outcomes included recurrent VTE, death, and different bleeding events. Adjusted hazard ratio (HR) analysis suggested that apixaban had significant lower bleeding riskthan rivaroxaban (major, minor and any bleeding: HR = 0.61, 0.56, 0.70; p = 0.008, < 0.0001, 0.006, respectively), but no statistics difference found in recurrent VTE events (HR = 1.02, 95% confidence interval (CI) 0.71–1.47, p = 0.93). There was no significant difference of major bleeding between dabigatran and rivaroxaban (odds ratios (OR) = 0.41, 95% CI 0.09–1.90, p = 0.25), apixaban and dabigatran (OR 0.64, 95% CI 0.15–2.72, p = 0.83). No significant difference was found in the comparison of edoxaban and other NOACs in VTE recurrence, major bleeding and composite outcome. In the prevention of bleeding events, apixaban was associated with a lower risk than rivaroxaban, but equivalent efficacy for different NOACs in prevention of recurrent VTE. Evidence generated from the meta-analysis based on real-world data can help to guide selection between apixaban and rivaroxaban in routine clinical practice. Trial registration: This systematic review and meta-analysis were conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis and Meta-analysis of Observational Studies in Epidemiology statements and was registered with PROSPERO (CRD42019140553). The online version contains supplementary material available at 10.1186/s12872-022-02550-8.
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影响因子：
3.7
作者：
Cohen AT;Hamilton M;Mitchell SA;Phatak H;Liu X;Bird A;Tushabe D;Batson S
通讯作者：
Batson S
影响因子：
2.9
作者：
Oremus M;Oremus C;Hall GB;McKinnon MC;ECT & Cognition Systematic Review Team
通讯作者：
ECT & Cognition Systematic Review Team
影响因子：
7.7
作者：
Sanderson, Simon;Tatt, Lain D.;Higgins, Julian P. T.
通讯作者：
Higgins, Julian P. T.
DOI：
10.1093/ehjcvp/pvy021
发表时间：
2018-10-01
影响因子：
7.1
作者：
Sindet-Pedersen, Caroline;Staerk, Laila;Olesen, Jonas Bjerring
通讯作者：
Olesen, Jonas Bjerring
影响因子：
9.6
作者：
Kearon, Clive;Akl, Elie A.;Moores, Lisa
通讯作者：
Moores, Lisa