VTE recurrence similar in patients on DOACs weighing ≥120 vs <120 kg

The recurrence of venous thromboembolism (VTE) is comparable in patients on direct-acting oral anticoagulants (DOACs) weighing ≥120 and those weighing <120 kg, with few events in either group, a recent study has shown.

“DOACs present a favourable alternative to warfarin based on the decreased burden of monitoring and fewer drug and food interactions,” the authors said. “Although studied in the general population, limited clinical data justifying efficacy in patients weighing ≥120 kg present concern for using DOACs in this specific population.”

To address this, the authors carried out a retrospective database analysis on patients receiving apixaban, dabigatran, or rivaroxaban for the treatment of VTE from the Veterans Integrated Service Network 8 between January 2012 and June 2017.

The incidence of recurrent VTEs while on anticoagulation was the primary outcome. The authors used Fisher’s exact tests to assess the difference in VTEs between the study groups.

A total of 1,063 patients weighing <120 kg and 133 weighing ≥120 kg were identified to have met the eligibility criteria during the 5-year time frame.

No statistically significant difference was seen in the incidence of recurrent VTEs between the two groups (0.8 percent vs 1.1 percent; odds ratio, 0.66, 95 percent confidence interval, 0.09–5.14; p=0.69). However, there were few events that occurred, which somehow limited the power to be able to detect a difference.

“Although promising, additional studies are needed to confirm these findings,” the authors said.