An IVC filter and anticoagulation for 3 months is unlikely to show a benefit over anticoagulation alone for high-risk patients with acute pulmonary embolism

Commentary on: Mismetti P, Laporte S, Pellerin O, et al; PREPIC2 Study Group. Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial. JAMA 2015;313:1627–35. Context Placement of an inferior vena cava (IVC) filter to prevent pulmonary embolism (PE) is recommended by multidisciplinary consensus guidelines only when anticoagulation is contraindicated, has resulted in a complication or has failed.1 2 Oddly, the only prospective randomised long-term filter efficacy study that demonstrated a reduction in the recurrent PE rate at 8-year follow-up (6.3% vs 15.1%) did so in a setting where both filter and no filter arms were also treated with anticoagulation.3 4 Although there were fewer PEs in the filter group at each time point, this benefit only reached statistical significance at 8-year follow-up, while the study...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: Journalology, Clinical trials (epidemiology), Drugs: cardiovascular system, Heart failure, Stroke, Venous thromboembolism, Pulmonary embolism, Ethics Therapeutics/Prevention Source Type: research