Sylvia Haas1, Walter Ageno2, Jeffrey I Weitz3, Samuel Z Goldhaber4, Alexander G G Turpie5, Shinya Goto6, Pantep Angchaisuksiri7, Joern Dalsgaard Nielsen8, Gloria Kayani9, Audrey Zaghdoun9, Alfredo E Farjat9, Sebastian Schellong10, Henri Bounameaux11, Lorenzo G Mantovani12, Paolo Prandoni13, Ajay K Kakkar9,14. 1. Formerly Technical University of Munich, Munich, Germany. 2. Department of Medicine and Surgery, University of Insubria, Varese, Italy. 3. Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, ON, Canada. 4. Harvard Medical School, Boston, Massachusetts. 5. McMaster University, Hamilton, ON, Canada. 6. Department of Medicine (Cardiology), Tokai University School of Medicine, Kanagawa, Japan. 7. Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 8. Copenhagen University Hospital, Copenhagen, Denmark. 9. Thrombosis Research Institute, London, UK. 10. Medical Department 2, Municipal Hospital Dresden, Dresden, Germany. 11. Faculty of Medicine, University Hospital of Geneva, Geneva, Switzerland. 12. University degli Studi di Milano Bicocca, Milan, Italy. 13. Arianna Foundation on Anticoagulation, Bologna, Italy. 14. University College London, London, UK.
Abstract
BACKGROUND: Parenteral anticoagulants and vitamin K antagonists (VKAs) have constituted the cornerstone of venous thromboembolism (VTE) treatment. Meanwhile, direct oral anticoagulants (DOACs) provide physicians with an alternative. The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE observes real-world treatment practices. OBJECTIVES: Describe initial anticoagulation (AC) treatment patterns in VTE patients who received parenteral AC, VKAs, and/or DOACs within ±30 days of diagnosis. METHODS: VTE patients were categorized into parenteral AC only, parenteral AC with transition to VKA, VKA only, parenteral AC with transition to DOAC, and DOAC only. RESULTS: A total of 9647 patients were initiated on AC treatment alone. 4781 (49.6%) patients received DOACs ± parenteral ACs; 3187 (33.0%), VKA ± parenteral ACs; and 1679 (17.4%) parenteral ACs alone. Rivaroxaban was the most frequently used DOAC (79.4%). DOACs were more frequently used in North America/Australia (58.1%), Europe (52.2%), and Asia (47.6%) than in Latin America (29.7%) and the Middle East/South Africa (32.5%). In patients with suspected VTE, most received parenteral AC monotherapy (67.7%). Patients with deep vein thrombosis were more likely to receive DOACs alone than those with pulmonary embolism with or without deep vein thrombosis (36.2% vs 25.9%). Active cancer patients received parenteral AC alone (58.9%), with 25.5% receiving DOAC ± parenteral AC and 12.8% parenteral AC and VKA. A total of 46.5% of pregnant patients received parenteral AC monotherapy, 34.0% were treated with VKA ± parenteral AC, and 19.5% received a DOAC (± parenteral AC). CONCLUSION: AC treatment patterns vary by patient population, geographic region and site of VTE. Guidelines for AC therapy are not always adhered to.
BACKGROUND: Parenteral anticoagulants and vitamin K antagonists (VKAs) have constituted the cornerstone of venous thromboembolism (VTE) treatment. Meanwhile, direct oral anticoagulants (DOACs) provide physicians with an alternative. The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE observes real-world treatment practices. OBJECTIVES: Describe initial anticoagulation (AC) treatment patterns in VTEpatients who received parenteral AC, VKAs, and/or DOACs within ±30 days of diagnosis. METHODS:VTEpatients were categorized into parenteral AC only, parenteral AC with transition to VKA, VKA only, parenteral AC with transition to DOAC, and DOAC only. RESULTS: A total of 9647 patients were initiated on AC treatment alone. 4781 (49.6%) patients received DOACs ± parenteral ACs; 3187 (33.0%), VKA ± parenteral ACs; and 1679 (17.4%) parenteral ACs alone. Rivaroxaban was the most frequently used DOAC (79.4%). DOACs were more frequently used in North America/Australia (58.1%), Europe (52.2%), and Asia (47.6%) than in Latin America (29.7%) and the Middle East/South Africa (32.5%). In patients with suspected VTE, most received parenteral AC monotherapy (67.7%). Patients with deep vein thrombosis were more likely to receive DOACs alone than those with pulmonary embolism with or without deep vein thrombosis (36.2% vs 25.9%). Active cancerpatients received parenteral AC alone (58.9%), with 25.5% receiving DOAC ± parenteral AC and 12.8% parenteral AC and VKA. A total of 46.5% of pregnant patients received parenteral AC monotherapy, 34.0% were treated with VKA ± parenteral AC, and 19.5% received a DOAC (± parenteral AC). CONCLUSION:AC treatment patterns vary by patient population, geographic region and site of VTE. Guidelines for AC therapy are not always adhered to.
Authors: Synne G Fronas; Anders E A Dahm; Hilde S Wik; Camilla T Jørgensen; Jostein Gleditsch; Nezar Raouf; René Holst; Frederikus A Klok; Waleed Ghanima Journal: Blood Adv Date: 2020-06-09
Authors: Walter Ageno; Alfredo Farjat; Sylvia Haas; Jeffrey I Weitz; Samuel Z Goldhaber; Alexander G G Turpie; Shinya Goto; Pantep Angchaisuksiri; Joern Dalsgaard Nielsen; Gloria Kayani; Sebastian Schellong; Henri Bounameaux; Lorenzo G Mantovani; Paolo Prandoni; Ajay K Kakkar Journal: Res Pract Thromb Haemost Date: 2021-02-20
Authors: Cecilia Becattini; Giancarlo Agnelli; Aldo Pietro Maggioni; Francesco Dentali; Andrea Fabbri; Iolanda Enea; Fulvio Pomero; Maria Pia Ruggieri; Andrea Di Lenarda; Michele Gulizia Journal: Intern Emerg Med Date: 2022-01-04 Impact factor: 5.472