ArticleInternational journal of general medicine2023
Real-World Evaluation of the Safety and Effectiveness of Apixaban & Rivaroxaban Lead-in Dosing Compared to Parenteral Lead-in Dosing in the Treatment of Venous Thromboembolism: A Multi-Center Retrospective Cohort Study.
Article in International journal of general medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- Real-World Bleeding Outcomes Among Hospitalized Patients Receiving Apixaban or Rivaroxaban: A Single-Center Retrospective Cohort Study.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Practice patterns of DOAC high-intensity period following parenteral lead-in treatment for venous thromboembolism.Journal of thrombosis and thrombolysis · 2026Article
- Treatment failure in patients with obesity with venous thromboembolism receiving truncated vs. recommended lead-in times with apixaban at an academic medical center.Journal of thrombosis and thrombolysis · 2026Article
- Does direct oral anticoagulant lead-in dosing following initial parenteral therapy affect clinical outcomes in acute venous thromboembolism?: A retrospective cohort study.International journal of clinical pharmacy · 2025Article
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Authors and funding
13 authors at 5 institutions in 1 country.
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Abstract
Background: Although parenteral anticoagulation lead-in is not recommended with apixaban and rivaroxaban, parenteral anticoagulation is often used to replace apixaban or rivaroxaban lead-in doses for the initial phase treatment of VTE. Thus, our study compares the safety and effectiveness of lead-in parenteral anticoagulation to lead-in apixaban or rivaroxaban in patients who received apixaban or rivaroxaban for VTE treatment. Methods: A multi-center retrospective cohort study included adult patients (aged ≥ 18 years) admitted to the hospital with acute VTE and treated with either apixaban or rivaroxaban. Patients were grouped depending on the lead-in anticoagulation received for initial VTE treatment into the "Direct oral anticoagulation (DOAC) lead-in" group if patients received an appropriate lead-in dose of apixaban and rivaroxaban and patients who received parenteral lead-in the "parenteral lead-in" group. Results: A total of 389 patients were included; the DOAC lead-in group included 296 patients, whereas 93 patients were in the parenteral lead-in group. VTE recurrence (rVTE) during hospitalization and within 30 days was numerically higher in the parenteral lead-in group compared to the DOAC lead-in group (3.3% vs 0.6%; Conclusion: Parenteral anticoagulation lead-in before starting maintenance of apixaban and rivaroxaban showed a significantly higher risk of bleeding and a trend toward higher VTE recurrence than the DOAC lead-in. This study adds to the evidence supporting the utilization of the DOAC lead-in regimen in treating patients with VTE. Still, larger studies with robust designs are needed to confirm these findings.
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