Evidence map›Paper›PMID 36564588›Full record

Observational studyJournal of thrombosis and thrombolysis2023

Effectiveness and safety of direct oral anticoagulants in patients with venous thromboembolism and creatinine clearance < 30 mL/min.

Lauren Cline, Erika Marie G Generoso, Nicholas D'Apice, Sara K Dellinger, Amber Tovey, Nathan P Clark, Fang Nui, Rita Hui, Stephanie A Hale, Tanya Ramsey and 6 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of thrombosis and thrombolysis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 25% 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

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
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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

16 authors at 5 institutions in 2 countries.

Lauren ClinePharmacy Department, University of Maryland St. Joseph Medical Center, Towson, MD, USA.
Erika Marie G GenerosoPharmacy Department, Kaiser Permanente Southern California, Woodland Hills, CA, USA.
Nicholas D'ApicePharmacy Department, Boston Medical Center, Boston, MA, USA.
Sara K DellingerPharmacy Department, Kaiser Permanente Georgia, Atlanta, GA, USA.
Amber ToveyPharmacy Department, Kaiser Permanente Northwest, Portland, OR, USA.
Nathan P ClarkPharmacy Department, Kaiser Permanente Colorado, Aurora, CO, USA.
Fang NuiPharmacy Outcomes Research Group, Kaiser Permanente National Pharmacy, Downey, CA, USA.
Rita HuiPharmacy Outcomes Research Group, Kaiser Permanente National Pharmacy, Oakland, CA, USA.
Stephanie A HalePharmacy Department, Kaiser Permanente Georgia, Atlanta, GA, USA.
Tanya RamseyPharmacy Department, Kaiser Permanente Northwest, Portland, OR, USA.
Kimi PontoppidanPharmacy Department, Kaiser Permanente Southern California, Woodland Hills, CA, USA.
Hasmig EkmekdjianPharmacy Department, Kaiser Permanente Southern California, Woodland Hills, CA, USA.
Kristen FinkPharmacy Department, Kaiser Permanente Mid-Atlantic States, Hyattsville, MD, USA.
Daniel M WittCollege of Pharmacy, University of Utah, Salt Lake City, UT, USA.
Mark A CrowtherDepartment of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
Thomas DelatePharmacy Outcomes Research Group, Kaiser Permanente National Pharmacy, 16601 E. Centretech Pkwy, Aurora, CO, 80011, USA. tom.delate@kp.org.ORCID http://orcid.org/0000-0002-6530-8415
Kaiser Permanente · USBoston Medical Center · USMcMaster University · CASt. Joseph Medical Center · USUniversity of Utah · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The few studies that compared direct oral anticoagulants (DOAC) vs. warfarin in the setting of advanced renal insufficiency have focused on patients with atrial fibrillation. The purpose of this observational, matched, cohort study of patients was to assess the effectiveness and safety of DOAC vs. warfarin for the treatment of venous thromboembolism (VTE) among patients with a creatinine clearance (CrCl) < 30 mL/min. This observational, cohort study included patients with VTE and CrCl < 30 mL/min who were newly initiated on a DOAC or warfarin between January 1, 2016 and December 31, 2020. DOAC patients were matched up to 1:2 to warfarin patients. Primary outcome was a composite of recurrent VTE, clinically-relevant bleeding, ischemic stroke, and all-cause mortality. Adjusted conditional, multivariate Cox proportional hazards modeling was used to assess outcomes. 626 DOAC patients were matched to 1071 warfarin patients. DOAC patients had a higher mean age, higher mean baseline CrCl, and were less likely to have been receiving dialysis. There was no statistically significant difference in the composite outcome between groups (adjusted hazard ratio [aHR] 1.13, 95% confidence interval [CI] 0.87-1.47) or in the individual components of the composite (all HR 95% CI crossed 1.00). Identification of statistically non-significant rates of bleeding and thromboembolic outcomes suggest that the use of DOAC or warfarin is reasonable in patients with VTE and CrCl < 30 mL/min.

Indexed as

Atrial FibrillationVenous ThromboembolismAdministration, OralAnticoagulantsCohort StudiesCreatinineHemorrhageHumansRetrospective StudiesWarfarinAnticoagulantsCreatinineWarfarinCreatinineFactor Xa inhibitorsSafetyVenous thromboembolismWarfarin

Identifiers

PMID36564588
OpenAlexW4312129019

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.