ArticleHepatology international2021
A network meta-analysis of direct oral anticoagulants for portal vein thrombosis in cirrhosis.
Article in Hepatology international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 6 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 6 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Recommendations for the safe use of direct oral anticoagulants in patients with cirrhosis based on a systematic review of pharmacokinetic, pharmacodynamic and safety data.European journal of clinical pharmacology · 2024Pooled it
- [Efficacy evaluation of novel oral anticoagulants in patients with cirrhosis accompanied with portal vein thrombosis: a meta-analysis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Pooled it
- Direct oral anticoagulants versus standard anticoagulation in children treated for acute venous thromboembolism.Pediatric research · 2023Pooled it
- Effect of Direct Oral Anticoagulants Versus Traditional Anticoagulation in Budd-Chiari Syndrome.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Comparative Effectiveness and Safety of Various Anticoagulation Regimens for Portal Venous Thrombosis in Cirrhosis: A Systematic Review and Network Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Direct Oral Anticoagulants Versus Traditional Anticoagulation in Cirrhotic Patients with Portal Vein Thrombosis: Updated Systematic Review.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Challenges in the management of vascular liver disorders in women in the reproductive period.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Review
- Navigating the Hemostatic Balance: Anticoagulation and Antiplatelet Therapy in Patients with Thrombocytopenia.Journal of clinical medicine · 2026Review
- Non-tumoral portal vein thrombosis in liver transplantation: Surgical perspectives and institutional protocol.World journal of gastrointestinal surgery · 2025Review
- Venous Thromboembolism in Unusual Locations.The Medical clinics of North America · 2025Review
- Outpatient management after hospitalisation for acute decompensation of cirrhosis: A practical guide.World journal of hepatology · 2024Review
- Direct oral anticoagulants in cirrhosis: Rationale and current evidence.JHEP reports : innovation in hepatology · 2024Review
- Use of direct oral anticoagulants for venous thromboembolism treatment at extremes of body weight, renal and liver function: an illustrated review.Research and practice in thrombosis and haemostasis · 2023Article
- Direct oral anticoagulants in the treatment of portal vein thrombosis in patients with portal hypertension.Clinical liver disease · 2023Article
- Anticoagulation in Patients with Liver Cirrhosis: Friend or Foe?Digestive diseases and sciences · 2023Review
- [New recognition of portal vein thrombosis mechanism and treatment in cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2022Review
- Direct Oral Anticoagulants for Portal Vein Thrombosis in Cirrhosis: From Pharmacology to Clinical Practice.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisReview
- Inpatient management of thrombosis and hemostasis in patients with cirrhosis.Clinical liver diseaseReview
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent guidelines have limited consensus on the approach to portal venous thrombosis (PVT) in cirrhotic patients. While there is rising interest in direct oral anticoagulants (DOACs) use for PVT, current evidence is limited by small sample size and lack of comparisons to traditional anticoagulants. Thus, a network meta-analysis was conducted to compare the use of DOACs with traditional anticoagulants.
methodsMedline and Embase were searched for articles about anticoagulation use in cirrhotic patients with nontumorous PVT for articles on DOACs, warfarin, low-molecular weight heparin (LMWH) or antithrombin III. A network analysis was conducted using risk ratios (RR) with surface under the cumulative ranking curve (SUCRA). A single-arm meta-analysis was used to summarize the outcomes of DOAC treatment.
resultsA total of 10 articles were included in the study. 79.5% (CI 38.8-95.9) of DOACs patients achieved complete or partial recanalization and 9.80% (CI 4.50-20.0) experienced a bleeding event. DOACs were superior to LMWH (RR 2.299, CI 1.037-5.093, p = 0.040), warfarin (RR 1.762, CI 1.017-3.053, p = 0.043) and no treatment (RR 3.489, CI 1.394-8.733, p = 0.008) in complete recanalization. For partial recanalization, while DOACs were not superior to any treatment, they had the highest probability in achieving partial recanalization in SUCRA analysis. Bleeding risk and mortality were similar compared to other treatments.
conclusionThe network analysis supports the use of DOACs in cirrhotic patients, with significant rates of complete recanalization compared to other treatments without increasing bleeding risk. DOACs can potentially be considered for nontumorous PVT in cirrhosis.
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