Evidence map›Paper›PMID 28210989›Full record

ArticleJournal of thrombosis and thrombolysis2017

Net clinical benefit of dabigatran vs. warfarin in venous thromboembolism: analyses from RE-COVER

Martin Feuring, Sam Schulman, Henry Eriksson, Ajay J Kakkar, Sebastian Schellong, Stefan Hantel, Elke Schueler, Jörg Kreuzer, Samuel Z Goldhaber

Open access · hybridAbstract readComparative Study
In one paragraph

Article in Journal of thrombosis and thrombolysis, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Warfarin involvement, in comparison to NOACs, in the development of systemic atherosclerosis.Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia · 2022
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 5 countries.

Martin FeuringBoehringer Ingelheim GmbH & Co. KG, 55216, Ingelheim am Rhein, Germany. martin.feuring@boehringer-ingelheim.com.
Sam SchulmanDepartment of Medicine, McMaster University and Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada.
Henry ErikssonDepartment of Medicine, Sahlgrenska University Hospital-Östra, Gothenburg, Sweden.
Ajay J KakkarThrombosis Research Institute and University College London, London, UK.
Sebastian SchellongMedical Division 2, Municipal Hospital Dresden-Friedrichstadt, Dresden, Germany.
Stefan HantelBoehringer Ingelheim GmbH & Co. KG, 55216, Ingelheim am Rhein, Germany.
Elke SchuelerAccovion GmbH, Eschborn, Germany.
Jörg KreuzerBoehringer Ingelheim GmbH & Co. KG, 55216, Ingelheim am Rhein, Germany.
Samuel Z GoldhaberCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Boehringer Ingelheim (Germany) · DEHarvard University · USMcMaster University · CASahlgrenska University Hospital · SEUniversity College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The direct oral anticoagulants, e.g., dabigatran etexilate (DE), are effective and well tolerated treatments for venous thromboembolism (VTE). Net clinical benefit (NCB) is a useful concept in weighing potential benefits against potential harm of comparator drugs. The NCB of DE vs. warfarin in VTE treatment was compared. Post-hoc analyses were performed on pooled data from the 6-month RE-COVER® and RE-COVER™ II trials, and data from the RE-MEDY™ trial (up to 36 months), to compare the NCB of DE (150 mg twice daily) and warfarin [target international normalized ratio (INR) 2.0-3.0]. Patients (≥18 years old) had symptomatic proximal deep vein thrombosis and/or pulmonary embolism. NCB was the composite of cardiovascular endpoints (non-fatal events of recurrent VTE, myocardial infarction, stroke or systemic embolism), all-cause death, and bleeding outcomes, all weighted equally. A broad definition of NCB included major bleeding events (MBE) and clinically relevant non-major bleeding events as bleeding outcomes, while a narrow definition included just MBE. The pooled dataset totalled 5107 patients from RE-COVER/RE-COVER II and 2856 patients from RE-MEDY. When NCB was narrowly defined, NCB was similar between DE and warfarin. When broadly defined, NCB was superior with DE vs. warfarin [RE-COVER/RE-COVER II, hazard ratio (HR) 0.80; 95% confidence interval (CI), 0.68-0.95 and RE-MEDY, HR 0.73; 95% CI 0.59-0.91]. These findings were unaffected by warfarin time in therapeutic range. The NCB of DE was similar or superior to warfarin, depending on the NCB definition used, regardless of the quality of INR control.

Indexed as

AdultAgedClinical Trials as TopicDabigatranFemaleHemorrhageHumansMaleMiddle AgedMyocardial InfarctionPulmonary EmbolismStrokeVenous ThromboembolismVenous ThrombosisWarfarinDabigatranWarfarinAnticoagulantDabigatran etexilateVenous thromboembolismWarfarin

Identifiers

PMID28210989
PMCPMC5375960
OpenAlexW2587944300

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.