Quality of life in patients with pulmonary embolism treated with edoxaban versus warfarin.
edoxaban
pulmonary embolism
quality of life
warfarin
Journal
Research and practice in thrombosis and haemostasis
ISSN: 2475-0379
Titre abrégé: Res Pract Thromb Haemost
Pays: United States
ID NLM: 101703775
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
21
04
2021
revised:
19
05
2021
accepted:
28
05
2021
entrez:
19
7
2021
pubmed:
20
7
2021
medline:
20
7
2021
Statut:
epublish
Résumé
Long-term sequelae of acute pulmonary embolism (PE) include decreased quality of life (QoL). Evidence suggests that adequacy of initial anticoagulant treatment in the acute phase of venous thrombosis has a key impact on late postthrombotic complications. We hypothesize that patients with acute PE treated with edoxaban for acute PE experience have improved QoL compared to those treated with warfarin. Patients with PE who participated in the Hokusai-VTE trial were contacted between June 2017 and September 2020 for a single long-term follow-up visit. Main outcomes were the generic and disease-specific QoL measured by the 36-Item Short Form Health Survey (SF-36) and Pulmonary Embolism Quality of Life questionnaire. We included 251 patients from 26 centers in eight countries, of which 129 (51%) had been assigned to edoxaban and 122 (49%) to warfarin. Patient- and thrombus-specific characteristics were similar in both groups. Mean time since randomization in the Hokusai-VTE trial was 7.0 years (standard deviation, 1.0). No relevant or statistical differences were observed in the QoL for patients treated with edoxaban compared to patients treated with warfarin. The mean difference between patients treated with edoxaban and patients with PE treated with warfarin was 0.8 (95% confidence interval [CI]. -1.6 to 3.2) for the SF-36 summary mental score and 1.6 (95% CI, -0.9 to 4.1) for summary physical score. Our findings indicate that patients with an index PE treated with edoxaban or warfarin have a similar long-term QoL. Since our study was a follow-up study from a well-controlled clinical trial setting, future studies should be designed in a daily clinical practice setting. We suggest a longitudinal design for investigation of changes in QoL over time.
Sections du résumé
BACKGROUND
BACKGROUND
Long-term sequelae of acute pulmonary embolism (PE) include decreased quality of life (QoL). Evidence suggests that adequacy of initial anticoagulant treatment in the acute phase of venous thrombosis has a key impact on late postthrombotic complications. We hypothesize that patients with acute PE treated with edoxaban for acute PE experience have improved QoL compared to those treated with warfarin.
METHODS
METHODS
Patients with PE who participated in the Hokusai-VTE trial were contacted between June 2017 and September 2020 for a single long-term follow-up visit. Main outcomes were the generic and disease-specific QoL measured by the 36-Item Short Form Health Survey (SF-36) and Pulmonary Embolism Quality of Life questionnaire.
RESULTS
RESULTS
We included 251 patients from 26 centers in eight countries, of which 129 (51%) had been assigned to edoxaban and 122 (49%) to warfarin. Patient- and thrombus-specific characteristics were similar in both groups. Mean time since randomization in the Hokusai-VTE trial was 7.0 years (standard deviation, 1.0). No relevant or statistical differences were observed in the QoL for patients treated with edoxaban compared to patients treated with warfarin. The mean difference between patients treated with edoxaban and patients with PE treated with warfarin was 0.8 (95% confidence interval [CI]. -1.6 to 3.2) for the SF-36 summary mental score and 1.6 (95% CI, -0.9 to 4.1) for summary physical score.
CONCLUSION
CONCLUSIONS
Our findings indicate that patients with an index PE treated with edoxaban or warfarin have a similar long-term QoL. Since our study was a follow-up study from a well-controlled clinical trial setting, future studies should be designed in a daily clinical practice setting. We suggest a longitudinal design for investigation of changes in QoL over time.
Identifiants
pubmed: 34278193
doi: 10.1002/rth2.12566
pii: S2475-0379(22)01426-1
pmc: PMC8279124
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e12566Informations de copyright
© 2021 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).
Références
Chest. 2016 Feb;149(2):315-352
pubmed: 26867832
J Vasc Surg Venous Lymphat Disord. 2015 Jul;3(3):333-40
pubmed: 26992316
Thromb Res. 2018 Nov;171:84-91
pubmed: 30267974
Eur J Intern Med. 2008 Dec;19(8):625-9
pubmed: 19046730
Thromb Res. 2015 Jun;135(6):1087-92
pubmed: 25887632
Am J Med. 2017 Aug;130(8):990.e9-990.e21
pubmed: 28400247
Curr Opin Pulm Med. 2001 Sep;7(5):354-9
pubmed: 11584189
Ann Am Thorac Soc. 2016 Jul;13 Suppl 3:S201-6
pubmed: 27571001
Res Pract Thromb Haemost. 2020 Aug 02;4(6):958-968
pubmed: 32864549
Semin Intervent Radiol. 2018 Jun;35(2):92-98
pubmed: 29872243
Thromb Res. 2013 Nov;132(5):500-5
pubmed: 24090607
Chest. 2010 Dec;138(6):1432-40
pubmed: 20495104
J Thromb Haemost. 2010 Mar;8(3):523-32
pubmed: 20025645
N Engl J Med. 2013 Oct 10;369(15):1406-15
pubmed: 23991658
Thromb Res. 2018 Apr;164:170-176
pubmed: 28760416
Thromb Res. 2020 Jun;190:69-75
pubmed: 32315869
Health Qual Life Outcomes. 2014 Dec 03;12:174
pubmed: 25464821
Eur Respir J. 2019 Oct 9;54(3):
pubmed: 31473594
J Thromb Haemost. 2005 May;3(5):939-42
pubmed: 15869588
Blood Rev. 2014 Nov;28(6):221-6
pubmed: 25168205