The safety and efficacy of nonvitamin K antagonist oral anticoagulants (NOACs) for the treatment of venous thromboembolism (VTE) have been established in randomized controlled trials, but limited data are available on their use in clinical practice across geographical regions.
In the international RE-COVERY DVT/PE™ observational study (enrollment January 2016 to May 2017), we sought to characterize the patient population and describe the prescribed anticoagulant. Patient characteristics and anticoagulants administered after objective diagnosis of venous thromboembolism were recorded at the baseline visit and again at hospital discharge or at 14 days after the diagnosis, whichever was later.
A total of 6095 patients were included, 50.2% were male, and the mean age was 61.5 years. The most common comorbidities were hypertension (35%), diabetes mellitus (11%), cancer (11%), prior venous thromboembolism (11%), and trauma/surgery (7%). Overall, 77% of patients received oral anticoagulants, with 54% on NOACs and 23% on vitamin K antagonists (VKAs); 20% received parenteral anticoagulation only. NOACs comprised about 60% of anticoagulant treatment in Europe and Asia but substantially less in Latin America (29%) and the Middle East (21%). For NOAC therapies, the distribution (as a percentage of the total cohort) was rivaroxaban 25.6%, dabigatran 15.5%, apixaban 11.3%, and edoxaban 1.7%. Treatment with NOACs was less frequent in patients who had cancer, chronic renal disease, heart failure, or stroke.
These findings enhance our understanding of venous thromboembolism patient baseline characteristics and the initial management of venous thromboembolism patients in routine practice.
NCT02596230 (ClinicalTrials.gov).
The American journal of medicine. 2020 Apr 20 [Epub ahead of print]
Samuel Z Goldhaber, Walter Ageno, Ivan B Casella, Kok Han Chee, Sebastian Schellong, Daniel E Singer, Marc Desch, Paul A Reilly, Esther Donado, Wenbo Tang, Isabelle Voccia, Sam Schulman
Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: ., University of Insubria, Varese, Italy., University of São Paulo, São Paulo, Brazil., University of Malaya, Kuala Lumpur, Malaysia., Stãdtisches Klinikum Dresden, Dresden, Germany., Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts., Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany., Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, Connecticut., Boehringer Ingelheim Canada, Burlington, Ontario, Canada., Thrombosis and Atherosclerosis Research Institute and McMaster University, Hamilton, Ontario, Canada; Department of Obstetrics and Gynecology, The First I.M. Sechenov Moscow State Medical University, Moscow, Russia.