An increasing number of existing oral anticoagulation regimes being changed to apixaban, however the proportion of the off-label dosages of all the oral anticoagulants remain stable, according to a recent study.
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| Photo: Anticoagulants also known as 'Blood Thinners' | InStyleHealth |
Furthermore, there is no difference seen in bleeding
rates, de novo strokes or thromboembolisms between the anticoagulants, as well
as between correct and off-label dosages.
Researchers said that, “Recently published studies
indicated a high proportion of patients taking direct oral anticoagulants are
off-label under or overdosed.”
Retrospective cohort study required whether off-label
dosages were corrected over time and whether off-label doses were correlated
with differences in bleeding rates, ischemic stroke, or venous thromboembolism.
The patients who showed during the emergency department
between January 1st and December 31st 2018 with
therapeutic oral anticoagulation (e.g., vitamin K antagonists, apixaban, rivaroxaban,
edoxaban, and dabigatran) were included and monitored for a maximum of 2 years
until December 31st 2019.
Experts then performed the detailed chart reviews for
each case involving characteristics, indication, bleeding complications, or modifications
in the used substance or dosage.
There was a total of 2,588 consultations of the 1,228
patients on therapeutic oral anticoagulation were evaluated. Vitamin K antagonist
(VKA) and rivaroxaban lost the largest proportions of users in favor of
apixaban during the maximum follow-up of 2 years. However, the overall
distribution of dosage accuracy remained almost unimproved.
There were no differences seen in the corresponding
results with respect to bleeding events or incidence, stroke or with venous
thromboembolism among various anticoagulants, as well as correct and off-label
doses. For more details about the study, click here.
Source: Am J Med 2021;134:E165-E170