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Increasing Number Seen in Anticoagulants Use, Off-label Dosage Remain Stable, Study Finds

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.

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
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