6 versus 30 months anticoagulation for recurrent venous thrombosis in patients with high factor VIII

Eischer, Lisbeth; Gartner, Verena; Schulman, Sam; Kyrle, Paul A.; Eichinger, Sabine

doi:10.1007/s00277-008-0626-1

Cited by 41 publications

(25 citation statements)

References 19 publications

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“…11 The present patient had no further thromboembolic events after starting low-dose aspirin therapy.…”

Section: Discussionmentioning

confidence: 80%

Untitled

2014

Exp Clin Transplant

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Thromboembolism is a complication of hematopoietic stem cell transplant. However, a literature search showed no previous reports of cerebral infarction during the thrombocytopenic stage after hematopoietic stem cell transplant. A 35-year-old woman with acute lymphoblastic leukemia (precursor B-cell type) was treated with hematopoietic stem cell transplant after induction and consolidation chemotherapy. On day 2 after transplant, she was unconscious, and had urinary incontinence and left hemiplegia. A computed tomography scan of the brain showed an acute ischemic infarct in the right middle cerebral artery region and an old infarct at the left thalamus without atherosclerosis. Factor VIII level was elevated (190%; normal range, 60% to 150%). She was treated with rehabilitation and low-dose aspirin. At 6 months after transplant, the leukemia remained in remission and she had no further thromboembolic events. This case suggests that prudent treatment of patients who have hematopoietic stem cell transplant may include monitoring for thromboembolism and testing factor VIII level before transplant.

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“…11 The present patient had no further thromboembolic events after starting low-dose aspirin therapy.…”

Section: Discussionmentioning

confidence: 80%

Untitled

2014

Exp Clin Transplant

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“…After duplicates were removed, 928 citations were screened for inclusion. Of those, 890 and 27 citations were excluded at the abstract and full text level, respectively, leaving 11 citations reporting 12 unique trials [9][10][11][12][13][14][15][16][17][18][19] (Table 1). Rivaroxaban 12 and idraparinux 16 were each evaluated in comparison to placebo in individual trials ( Figure 2).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…13 VKAs were compared to either placebo or control (i.e., discontinuation of VKA therapy with no placebo administration) in five trials. 9,10,[17][18][19] Finally, aspirin was compared to placebo in two trials. 14,15 Six trials were judged to…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…16,19 The remaining four trials, which all evaluated the active intervention of VKA, had unclear randomization procedures. 9,10,17,18 Three of these trials had high risk of bias because the trials were not blinded to participants and personnel. 9,17,18 The 10 trials in our base-case analysis represent a total of 11,079 patients.…”

Section: Accepted M Manuscriptmentioning

confidence: 99%

“…9,10,17,18 Three of these trials had high risk of bias because the trials were not blinded to participants and personnel. 9,17,18 The 10 trials in our base-case analysis represent a total of 11,079 patients. [11][12][13][14][15][16][17][18][19] With the exception of one trial that enrolled exclusively patients with an index DVT, the index event was (0.03 to 1.08)].…”

Section: Accepted M Manuscriptmentioning

confidence: 99%

See 2 more Smart Citations

Comparative efficacy and safety of anticoagulants and aspirin for extended treatment of venous thromboembolism: A network meta-analysis

Sobieraj

Coleman

Pasupuleti

et al. 2015

Thrombosis Research

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT Abstract (305 words)Objective: To systematically review the literature and to quantitatively evaluate the efficacy and safety of extended pharmacologic treatment of venous thromboembolism (VTE) through network meta-analysis (NMA).Methods: A systematic literature search (MEDLINE, Embase, Cochrane CENTRAL, throughSeptember 2014) and searching of reference lists of included studies and relevant reviews was conducted to identify randomized controlled trials of patients who completed initial anticoagulant treatment for VTE and then randomized for the extension study; compared extension of anticoagulant treatment to placebo or active control; and reported at least one outcome of interest (VTE or a composite of major bleeding or clinically relevant non-major bleeding). A random-effects Frequentist approach to NMA was used to calculate relative risks with 95% confidence intervals.Results: Ten trials (n=11,079) were included. Risk of bias (assessed with the Cochrane tool) was low in most domains assessed across the included trials. Apixaban (2.5mg and 5mg), dabigatran, rivaroxaban, idraparinux and vitamin K antagonists (VKA) each significantly reduced the risk of VTE recurrence compared to placebo, ranging from a 73% reduction with idraparinux to 86% with VKAs. With exception of idraparinux, all active therapies significantly reduced VTE recurrence risk versus aspirin, ranging from a 73% reduction with either apixaban 2.5mg or rivaroxaban to 80% with VKAs. Apixaban and aspirin were the only therapies that did not increase composite bleeding risk significantly compared to placebo. All active therapies except aspirin increased risk of composite bleeding by 2 to 4-fold compared to apixaban 2.5mg, with no difference found between the two apixaban doses. A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPTConclusion: Extended treatment of VTE is a reasonable approach to provide continued protection from VTE recurrence although bleeding risk is variable across therapeutic options.Our results indicate that apixaban, dabigatran, rivaroxaban, idraparinux and VKAs all reduced VTE recurrence when compared to placebo. Apixaban appears to have a more favorable safety profile compared to other therapies.

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