ArticleBritish journal of clinical pharmacology2020
Risk of major bleeding among users of direct oral anticoagulants combined with interacting drugs: A population-based nested case-control study.
Article in British journal of clinical pharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Drug-drug interactions with direct oral anticoagulants: development of a consensus list for ambulatory care.International journal of clinical pharmacy · 2023Guideline
- Use of serotonin reuptake inhibitor antidepressants and the risk of bleeding complications in patients on anticoagulant or antiplatelet agents: a systematic review and meta-analysis.Annals of medicine · 2022Pooled it
- Drug-drug interactions of NOACs with comedication: Prevalence and implications for adverse events in patients with atrial fibrillation.Heart rhythm O2 · 2026Article
- Potentially Clinically Significant Drug-Drug Interactions in Older Adults with Atrial Fibrillation and Multimorbidity: Prevalence, Correlates, and Association with Adverse Clinical Outcomes in a Swedish National Register-Based Study.Cardiovascular drugs and therapy · 2026Article
- Comparative bleeding risk between angiotensin II receptor blockers with high versus low P-glycoprotein inhibitory activity in patients with atrial fibrillation receiving direct oral anticoagulants.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Drug-drug interactions with direct oral anticoagulants in Belgian primary care patients with non-valvular atrial fibrillation.Scientific reports · 2026Article
- Association between concomitant use of direct oral anticoagulants with antidepressants and an increased risk of hemorrhage: analysis of the food and drug administration adverse event reporting system database.Frontiers in medicine · 2026Article
- Prevalence of Major Bleeding in Elderly Patients on Oral Anticoagulants for Non-Valvular Atrial Fibrillation: A Single-Center 12-Year Retrospective Review.Geriatrics (Basel, Switzerland) · 2025Article
- Real-World Impact of Amiodarone on Apixaban Population Pharmacokinetics in Hospitalized Patients.Clinical and translational science · 2025Article
- Association Between Statins Use and Major Bleeding in Patients Using Direct Oral Anticoagulants for Atrial Fibrillation.Pharmacoepidemiology and drug safety · 2025Article
- Silent Dangers in Elderly Pharmacotherapy: The Interplay of Polypharmacy, Multimorbidity, and Drug Interactions.Journal of evaluation in clinical practice · 2025Review
- Use of Direct Anticoagulants in Kidney Transplant Recipients: Review of the Current Evidence and Emerging Perspectives.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025Review
- Pharmacodynamic Drug-Drug Interactions and Bleeding Outcomes in Patients with Atrial Fibrillation Using Non-Vitamin K Antagonist Oral Anticoagulants: a Nationwide Cohort Study.Cardiovascular drugs and therapy · 2025Article
- Concomitant Use of Selective Serotonin Reuptake Inhibitors With Oral Anticoagulants and Risk of Major Bleeding.JAMA network open · 2024Article
- The Impact of Polypharmacy on the Effectiveness and Safety of Non-vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation.Thrombosis and haemostasis · 2024Article
- Effectiveness and Safety of Different Oral Anticoagulants with P-glycoprotein/ CYP3A4 Inhibitors: A Network Meta-analysis.Current pharmaceutical design · 2024Article
- Clinical Care Pathway and Management of Major Bleeding Associated with Nonvitamin K Antagonist Oral Anticoagulants: A Modified Delphi Consensus from Saudi Arabia and UAE.Mediterranean journal of hematology and infectious diseases · 2024Review
- Prevalence and bleeding risk associated with the concomitant use of direct oral anticoagulants and antiarrhythmic drugs in patients with atrial fibrillation, based on the French healthcare insurance database.European journal of clinical pharmacology · 2023Article
- Investigation of the anticoagulant activity of cyclic sulfated glycosaminoglycan mimetics.Carbohydrate research · 2023Article
- Selective Serotonin Reuptake Inhibitor Use and Risk of Major Bleeding during Treatment with Vitamin K Antagonists: Results of A Cohort Study.Thrombosis and haemostasis · 2023Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo assess the association between concurrent use of potential pharmacokinetic or pharmacodynamic interacting drugs and major bleeding among direct oral anticoagulant (DOAC) users.
methodsWe performed a case-control study nested in a cohort of new users of DOACs (dabigatran etexilate, apixaban or rivaroxaban). Data were obtained from the UK Clinical Practice Research Datalink linked to Hospital Episode Statistics (2008-2015). Cases were patients hospitalized having a primary diagnosis of major bleeding. Up to 4 controls were matched on age, sex, index date and region. Odds ratios (ORs) for the risk of major bleeding were assessed by conditional logistic regression analysis and adjusted for well-known covariates for the risk of bleeding.
resultsWe identified 393 patients with a major bleeding from a total of 23 492 new users of DOACs and 1494 matched controls. Most subjects were users of rivaroxaban (58.8%) on the index date. The concurrent use of pharmacodynamic interacting drugs was associated with an increased risk of major bleeding (21.6% of cases vs 13.5% of controls, adjusted odds ratio [aOR] 1.92; 95% confidence interval [CI], 1.40-2.66). For the antiplatelet drugs the aOR was 2.01 (95% CI, 1.29-3.11) and for the selective serotonin reuptake inhibitors the aOR was 1.68 (95% CI, 1.10-2.59). We found no increased risk of major bleeding for concurrent use of pharmacokinetic interacting drugs vs DOACs alone (45.0 vs 51.2%; aOR: 0.77; 95% CI: 0.53-1.10).
conclusionAmong patients taking DOACs the concurrent use of antiplatelet drugs or selective serotonin reuptake inhibitors was associated with increased risk of major bleeding, while pharmacokinetic interacting drugs do not increase this risk.
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