Efficacy and safety of the new oral anticoagulants in the treatment of venous thromboembolic complications: meta-analysis
Abstract
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.
About the Authors
V. I. Petrov
Volgograd State Medical University. Pavshikh Bortsov pl. 1, Volgograd, 400131 Russia
Russian Federation
Russian Federation
O. V. Shatalova
Volgograd State Medical University. Pavshikh Bortsov pl. 1, Volgograd, 400131 Russia
Russian Federation
Russian Federation
V. S. Gorbatenko
Volgograd State Medical University. Pavshikh Bortsov pl. 1, Volgograd, 400131 Russia
Russian Federation
Russian Federation
O. N. Smuseva
Volgograd State Medical University. Pavshikh Bortsov pl. 1, Volgograd, 400131 Russia
Russian Federation
Russian Federation
A. S. Maslakov
Volgograd State Medical University. Pavshikh Bortsov pl. 1, Volgograd, 400131 Russia
Russian Federation
Russian Federation
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Review
For citations:
Petrov V.I., Shatalova O.V., Gorbatenko V.S., Smuseva O.N., Maslakov A.S. Efficacy and safety of the new oral anticoagulants in the treatment of venous thromboembolic complications: meta-analysis. Rational Pharmacotherapy in Cardiology. 2016;12(6):31-39.
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