Real World Experience of Direct Oral Anticoagulants with Comparison of Safety Outcomes to the Warfarin Era of Venous Thromboembolism Treatment

Conclusion:This retrospective audit shows that our local safety outcomes are comparable to clinical trials. Low dose anticoagulation and high falls risk (a surrogate marker of frailty) were significant risk factors for both clinically significant bleeding and thrombotic stroke in the DOAC population. These patients are likely frailer with greater co-morbidities and have shared risk factors for bleeding and stroke, suggesting that for these high risk patients, low dose anticoagulation does not negate their risk of complications and careful prescribing and close monitoring remain essential.The sub-comparison between VTE patients on DOAC and warfarin found that patients on warfarin had a higher rate of VTE recurrence in comparison to patients on DOAC. This may reflect patients maintaining more time on therapeutic anticoagulation with the more predictable DOACs compared to warfarin patients who may have more time below therapeutic range. There may also be a selection bias as-high risk patients with co-morbidities and those not meeting criteria for DOACs continue to be prescribed warfarin in the DOAC era. This data is similar to recent real-life DOAC experience in the atrial fibrillation population.Table 1.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - Category: Hematology Authors: Tags: 331. Pathophysiology of Thrombosis: Poster II Source Type: research