SynthesisJournal of thrombosis and thrombolysis2021
Switching between direct oral anticoagulants: a systematic review and meta-analysis.
Synthesis in Journal of thrombosis and thrombolysis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis 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
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Oral anticoagulants: a systematic overview of reviews on efficacy and safety, genotyping, self-monitoring, and stakeholder experiences.Systematic reviews · 2022Pooled it
- Oral anticoagulant switching in patients with atrial fibrillation: a long-term cohort study using population-level administrative data.International journal of clinical pharmacy · 2026Article
- Development and validation of a method to compare outcomes between switchers and continuers in routine clinical practice.Journal of comparative effectiveness research · 2026Article
- Drug-drug interactions with direct oral anticoagulants in Belgian primary care patients with non-valvular atrial fibrillation.Scientific reports · 2026Article
- Predictors of Direct Oral Anticoagulant Use in Northern Italy: A Population-Based Study.Pharmacoepidemiology and drug safety · 2025Article
- Cost-effectiveness and budget impact analysis of switching from apixaban to rivaroxaban treatment among patients with nonvalvular atrial fibrillation in a German healthcare setting.Journal of comparative effectiveness research · 2025Article
- Clinical Impact of Switching or Continuation of Apixaban or Rivaroxaban among Patients with Non-Valvular Atrial Fibrillation.Journal of clinical medicine · 2024Article
- Gastrointestinal bleeding among oral anticoagulant users: a comprehensive 7-year retrospective review using Türkiye's national health data system.Turkish journal of medical sciences · 2024Article
- Article
- Oral Anticoagulant Discontinuation and Its Predictors in Patients with Atrial Fibrillation.Journal of clinical medicine · 2022Article
- Comparison of the DOAC Dipstick Test on Urine Samples With Chromogenic Substrate Methods on Plasma Samples in Outpatients Treated With Direct Oral Anticoagulants.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisObservational
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.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Crossover between direct oral anticoagulants (DOACs) has been underinvestigated, but happens frequently in clinical practice. It is still unknown whether DOACs have similar rates of switch, or whether some DOACs are more prone to be switched over time. We reviewed studies comparing DOAC-to-DOAC switch prevalence, and compared risk of switch depending on index DOAC through meta-analysis. Systematic review followed PRISMA guidelines and deposited protocol (PROSPERO#CRD42020152405). MEDLINE, EMBASE, and Cochrane-CENTRAL were searched up to 1/3/2020 for studies reporting on DOAC-to-DOAC switch. We determined by meta-analysis the pooled odds ratio (OR) for switch depending on index DOAC prescribed. Newcastle-Ottawa Scale was used for bias assessment. Among 221 results retrieved, 5 large studies (n = 259,308, mean age ranging 61.2-79.3) provided data on DOAC-to-DOAC switch. Studies were all large retrospective, observational and claims registry-based, with similar ascertainment of exposure and switch. Bias assessment revealed fair to high quality. Among DOACs, apixaban had consistently lower risk of DOAC-to-DOAC switch compared to dabigatran (OR 0.29, 95% CI 0.25-0.34) or rivaroxaban (OR 0.58, 95% CI 0.50-0.67), the former carrying a higher risk than the latter (OR 2.35, 95% CI 1.93-2.86). Results were robustly confirmed by sensitivity analysis. Apixaban might carry a lower risk of DOAC-to-DOAC switch compared to dabigatran and rivaroxaban. Further studies are needed to confirm long-term safety and effectiveness of switching paradigm.
Indexed as
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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.