Evidence map›Paper›PMID 38916655›Full record

ReviewMedizinische Klinik, Intensivmedizin und Notfallmedizin2025

[Overdosing of direct oral anticoagulants].

Marie Anne-Catherine Neumann, Noëlle Sieg, Jorge Garcia Borrega, Christoph Hüser, Michael Caspers, Alexander Shimabukuro-Vornhagen, Boris Böll, Matthias Kochanek, Dennis A Eichenauer, Jan-Hendrik Naendrup

Abstract readReviewCase ReportsEnglish Abstract
PubMed Publisher
In one paragraph

Review in Medizinische Klinik, Intensivmedizin und Notfallmedizin, 2025. 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
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.

  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

10 authors.

Marie Anne-Catherine NeumannKlinik I für Innere Medizin, Centrum für integrierte Onkologie Aachen Bonn Köln Düsseldorf, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Noëlle SiegKlinik I für Innere Medizin, Centrum für integrierte Onkologie Aachen Bonn Köln Düsseldorf, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Jorge Garcia BorregaKlinik I für Innere Medizin, Centrum für integrierte Onkologie Aachen Bonn Köln Düsseldorf, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Christoph HüserKlinik II für Innere Medizin, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Köln, Deutschland.
Michael CaspersKlinik für Orthopädie, Unfallchirurgie und Sporttraumatologie, Kliniken der Stadt Köln-Merheim, Universität Witten/Herdecke (UW/H), Campus Köln-Merheim, Ostmerheimer Str. 200, 51109, Köln, Deutschland.
Alexander Shimabukuro-VornhagenKlinik I für Innere Medizin, Centrum für integrierte Onkologie Aachen Bonn Köln Düsseldorf, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Boris BöllKlinik I für Innere Medizin, Centrum für integrierte Onkologie Aachen Bonn Köln Düsseldorf, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Matthias KochanekKlinik I für Innere Medizin, Centrum für integrierte Onkologie Aachen Bonn Köln Düsseldorf, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Dennis A EichenauerKlinik I für Innere Medizin, Centrum für integrierte Onkologie Aachen Bonn Köln Düsseldorf, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Jan-Hendrik NaendrupKlinik I für Innere Medizin, Centrum für integrierte Onkologie Aachen Bonn Köln Düsseldorf, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland. jan-hendrik.naendrup@uk-koeln.de.ORCID http://orcid.org/0000-0002-6420-7938

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDirect oral anticoagulants (DOAC) are increasingly used for prophylaxis and treatment of thromboembolic events. Incorrectly dosed DOAC treatment is associated with excess mortality. PURPOSE: This article aims at raising awareness of DOAC overdosing and its causes as well as presenting a diagnostic and therapeutic work-up. MATERIAL AND

methodsBased on a case presentation, a structured review of the current literature on DOAC overdosing was performed and treatment recommendations were extracted.

resultsIn addition to wittingly or unwittingly increased DOAC intake, common causes of overdose are inadequate dose adjustment for concomitant medication or comorbidities. Global coagulation testing should be supplemented with DOAC-specific testing. Severe bleeding and the need for invasive diagnostics or urgent surgery represent indications for treating DOAC overdoses. Based on the cause of an DOAC overdose, active charcoal, endoscopic pill rescue, antagonization with idarucizumab or andexanet alfa and the targeted substitution of coagulation factors represent treatment options.

conclusionThe sensitization of clinicians is important to ensure a timely diagnosis and adequate treatment of DOAC overdosing. This report provides an overview of current knowledge on diagnostics and treatment; however, further studies are necessary to improve the existing algorithms.

Indexed as

AnticoagulantsDrug OverdoseFactor Xa InhibitorsAdministration, OralAntibodies, Monoclonal, HumanizedBlood Coagulation TestsHemorrhageHumansMaleAntibodies, Monoclonal, HumanizedAnticoagulantsFactor Xa InhibitorsidarucizumabAndexanet alfaApixabanDabigatranIdarucizumabRivaroxaban

Identifiers

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.