Evidence map›Paper›PMID 35873512›Full record

ArticleDEN open2022

Potential for replacing warfarin with a direct oral anticoagulant for endoscopic mucosal resection in the colorectum: A multicenter, open-label, randomized controlled trial.

Takuya Yamada, Toshio Kuwai, Yoshihiro Sasaki, Yuko Sakakibara, Toshio Uraoka, Motohiko Kato, Noriko Watanabe, Toshihisa Kimura, Akiko Kada, Akiko M Saito and 1 more

Open access · goldAbstract read
In one paragraph

Article in DEN open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 98% 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

1 citing paper in PubMed, 0 citations in OpenAlex.

  1. 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

11 authors at 7 institutions in 1 country.

Takuya YamadaDepartment of Gastroenterology and Hepatology National Hospital Organization Osaka National Hospital Osaka Japan.ORCID https://orcid.org/0000-0002-6531-409X
Toshio KuwaiDepartment of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer Center Hiroshima Japan.
Yoshihiro SasakiDepartment of Gastroenterology National Hospital Organization Disaster Medical Center Tokyo Japan.
Yuko SakakibaraDepartment of Gastroenterology and Hepatology National Hospital Organization Osaka National Hospital Osaka Japan.
Toshio UraokaDepartment of Gastroenterology National Hospital Organization Tokyo Medical Center Tokyo Japan.ORCID https://orcid.org/0000-0002-4425-4331
Motohiko KatoDepartment of Gastroenterology National Hospital Organization Tokyo Medical Center Tokyo Japan.
Noriko WatanabeDepartment of Gastroenterology National Hospital Organization Mie Chuo Medical Center Mie Japan.
Toshihisa KimuraDepartment of Surgery National Hospital Organization Tsuruga Medical Center Fukui Japan.
Akiko KadaClinical Research Center National Hospital Organization Nagoya Medical Center Aichi Japan.
Akiko M SaitoClinical Research Center National Hospital Organization Nagoya Medical Center Aichi Japan.
Naohiko HaradaDepartment of Gastroenterology Clinical Research Institute, National Hospital Organization Kyushu Medical Center Fukuoka Japan.
National Hospital Organization · JPOsaka National Hospital · JPKeio University · JPMie Chuo Medical Center · JPMunicipal Tsuruga Hospital · JPNational Kyushu Medical Center · JPTokyo Medical Center · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: This study aimed to evaluate the efficacy and safety of apixaban replacement (AR) as an alternative to heparin bridging (HB) in patients taking warfarin and scheduled for endoscopic mucosal resection (EMR) in the colorectum. Methods: This trial was conducted at seven institutes in Japan between May 2016 and May 2018. Enrolled patients had been taking oral warfarin and were diagnosed within 3 months with colorectal polyps for which EMR was indicated. Patients were randomly assigned to receive HB or AR. The primary endpoint was the incidence of postoperative bleeding. Secondary endpoints were the length of hospital stay, therapeutic endoscopy outcomes, and adverse events. Results: The planned sample size was 160 patients, but due to a decrease in the number of patients taking warfarin, the target number of cases could not be achieved within the case enrollment period, 44 cases were enrolled. They were divided into HB and AR groups. The incidence of postoperative bleeding was 15% (3/20) in HB and 0% in AR (P = 0.199). The total number of postoperative bleeding events was five in HB and none in AR. The length of hospital stay was significantly shorter in AR than in HB (median: 3.0 vs. 13.5 days, Conclusion: AR for colorectal EMR may prove safe and has the potential to shorten hospital stay and reduce medical costs, though we were unable to evaluate the primary endpoint due to insufficient sample size.

Indexed as

direct oral anticoagulantendoscopic mucosal resectionheparin bridgingrandomized controlled trialwarfarin

Identifiers

PMID35873512
PMCPMC9302298
OpenAlexW4213150425

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Registered trials

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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.