SynthesisThrombosis research2020
Drug-drug interactions with direct oral anticoagulants associated with adverse events in the real world: A systematic review.
Synthesis in Thrombosis research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 5 of them syntheses that pooled 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.
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.
Who cites it
47 citing papers in PubMed, 5 syntheses or guidelines pooled it, 77 citations in OpenAlex.
- Continuous vs interrupted direct oral anticoagulants for minimal bleeding-risk surgical procedures-a systematic review and meta-analysis.Research and practice in thrombosis and haemostasis · 2026Pooled it
- Effectiveness and safety of concomitant use of direct oral anticoagulants and antiarrhythmic drugs: a systematic review of observational studies.European journal of clinical pharmacology · 2025Pooled it
- Drug-drug interactions with direct oral anticoagulants: development of a consensus list for ambulatory care.International journal of clinical pharmacy · 2023Guideline
- Pooled it
- Treatment Algorithm in Cancer-Associated Thrombosis: Updated Canadian Expert Consensus.Current oncology (Toronto, Ont.) · 2021Pooled it
- Effect of Clarithromycin, a Strong CYP3A and P-glycoprotein Inhibitor, on the Pharmacokinetics of Edoxaban in Healthy Volunteers and the Evaluation of the Drug Interaction with Other Oral Factor Xa Inhibitors by a Microdose Cocktail Approach.Cardiovascular drugs and therapy · 2024Trial
- Exploring Risks of Adverse Drug Events From Single Drug to Three-Drug Combination.Clinical and translational science · 2026Article
- Drug-drug interactions with direct oral anticoagulants in Belgian primary care patients with non-valvular atrial fibrillation.Scientific reports · 2026Article
- The Use of Direct Oral Anticoagulants (DOACs) in Older Adults Receiving Multidose Drug Dispensing; Interactions, Anticholinergic and Fall-Risk Increasing Drugs.Geriatrics (Basel, Switzerland) · 2026Article
- Interactions Between Direct Oral Anticoagulants and Drugs Involving CYP-Enzymes and P-gp Transporters Detected by a Clinical Decision Support System: A Retrospective Cohort Study.Cardiovascular drugs and therapy · 2026Article
- An Overview of Anticoagulant Drugs Pharmacology, Therapeutic Approaches, Limitations and Perspectives.Pharmaceutics · 2026Review
- Atrial fibrillation and ischemic stroke in cancer: the latest scientific evidence, current management, and future directions.Journal of thrombosis and thrombolysis · 2025Review
- Rivaroxaban use during vitamin KResearch and practice in thrombosis and haemostasis · 2025Article
- Drug-Drug Interactions Between Direct Oral Anticoagulants and Other Medications in Patients with Pulmonary Embolism: Results from the Lungenembolie Augsburg (LEA).Clinical pharmacokinetics · 2025Article
- Potential Drug Dose-Specific Adverse Three-Drug Combinations: A US Insurance Claims Data-Based Study.Pharmacoepidemiology and drug safety · 2025Article
- Challenges and Opportunities of Direct Oral Anticoagulant (DOAC) Therapy in Complex Clinical Scenarios: A Comprehensive Review and Practical Guide.Journal of clinical medicine · 2025Review
- Association between dementia and left atrial appendage occlusion in patients with atrial fibrillation: A TriNetX-based retrospective cohort study with target trial emulation.Heart rhythm O2 · 2025Article
- Effect of the frequently used antiepileptic drugs carbamazepine, gabapentin, and pregabalin on the pharmacokinetics of edoxaban and other oral factor xa inhibitors in healthy volunteers.Frontiers in pharmacology · 2025Article
- Effect of drug interactions with apixaban on clinical outcomes in cancer patients with venous thromboembolism.Frontiers in oncology · 2025Article
- Pharmacological strategies for preventing post-stroke seizures and epilepsy.Frontiers in neurology · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDirect oral anticoagulants (DOACs) have emerged as safe and effective alternatives to Vitamin-K antagonists for treatment and prevention of arterial and venous thrombosis. Due to their novelty, pharmacokinetic DOAC drug-drug interactions (DDIs) that result in clinical adverse events have not been well-documented.
objectiveThis study aims to systematically review reported pharmacokinetic DDIs resulting in clinical adverse events through documented observational evidence to better inform clinicians in clinical practice.
methodsA comprehensive literature review of EMBASE, MEDLINE, and Ovid HealthStar was conducted through March 10th, 2020. Two independent reviewers screened and extracted data from eligible articles according to pre-established inclusion and exclusion criteria. Articles reporting bleeding or thrombotic outcomes in non-controlled (observational) settings resulting from suggested pharmacokinetic DOAC DDIs were included.
resultsA total of 5567 citations were reviewed, of which 24 were included following data extraction. The majority were case reports (n = 21) documenting a single adverse event resulting from a suspected DOAC DDI, while the remaining papers were a case series (n = 1) and cohort studies (n = 2). The most commonly reported interacting drugs were amiodarone and ritonavir (bleeding), and phenobarbital, phenytoin, and carbamazepine (thrombosis). Bleeding events more often resulted from a combined mechanism (P-glycoprotein AND CYP3A4 inhibition), whereas thrombotic events resulted from either combined OR single P-glycoprotein/CYP3A4 induction.
conclusionCurrent literature evaluating the real-world risk of DOAC DDIs is limited to few case reports and retrospective observational analyses. Clinicians are encouraged to continue to report suspected drug interactions resulting in adverse events.
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Registered trials
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.