VKAs vs. TSOACs and Bleeding Risk: New Findings
the MPR take:
While target-specific oral anticoagulants (TSOACs) have been shown in studies to be non-inferior to vitamin K antagonists (VKAs), the risk of bleeding is of particular concern. A systematic review and meta-analysis of Phase II randomized studies, published in the journal Blood, sought to assess the bleeding side effects of TSOACs vs. VKAs in patients with venous thromboembolism (VTE) or atrial fibrillation (A-fib). A total of 102,607 patients in 12 studies were evaluated and TSOACs were found to significantly reduce the risk of overall major bleeding, fatal bleeding, intracranial bleeding, clinically relevant non-major bleeding, and total bleeding. No significant gastrointestinal (GI) bleeding was seen between TSOACs and VKAs. Earlier this year, the Food and Drug Administration (FDA) announced that new users of Pradaxa (dabigatran etexilate mesylate; Boehringer Ingelheim) had a greater risk of GI bleeding compared to new warfarin patients.
Novel oral anticoagulants (TSOACs) have been developed and found to be at least non-inferior to VKAs with regards to efficacy but the risk of bleeding with TSOACs remains controversial. A total of 12 RCTs involving 102,607 patients were retrieved. TSOACs significantly reduced the risk of overall ...
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