A Systematic Review and Bayesian Network Meta-Analysis on the Effect of Different Anticoagulants on the Prophylaxis of Post-Thrombotic Syndrome after Deep Venous Thrombosis.
Bayesian network meta-analysis
Villalta score
anticoagulants
postthrombotic syndrome
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
30 Nov 2023
30 Nov 2023
Historique:
received:
30
09
2023
revised:
23
11
2023
accepted:
27
11
2023
medline:
9
12
2023
pubmed:
9
12
2023
entrez:
9
12
2023
Statut:
epublish
Résumé
Postthrombotic syndrome (PTS) has a major impact on the quality of life after deep venous thrombosis (DVT). From clinical practice and related trials, anticoagulants show potential for reducing the occurrence and alleviating the symptoms of PTS. A systematic review and Bayesian network meta-analysis (NMA) were conducted by combing the literature from the databases of MEDLINE, Embase, Web of Science, Cochrane Libraries, and ClinicalTrials, through a variety of medical subject headings (Mesh) and PTS keywords. With regard to PTS prophylaxis, all anticoagulant-related randomized controlled trials (RCTs) and observational studies were assessed. The network model was conducted through the R software, and further comparisons were conducted using the Bayesian hierarchical random effects model. The odds ratio (OR) and the corresponding 95% CI were calculated for analysis. Data from two RCTs and nine non-randomized studies meeting the selection criteria were included in the Bayesian analysis model, which incorporated seven anticoagulants. Edoxaban (OR: 0.42, 95% CI: 0.18-1.0) and rivaroxaban (OR: 0.54, 95% CI: 0.38-0.76) were significantly more effective than warfarin in the prevention of PTS (Villalta score ≥ 5). A subgroup analysis based on the severity of PTS showed that rivaroxaban was more effective than warfarin, with OR: 0.59, 95% CI: 0.41-0.84 (Villalta score 5 to 14) and OR: 0.48, 95% CI: 0.22-0.9 (Villalta score ≥ 15, ulceration), respectively. Edoxaban had the highest probability (80.1%) of providing preventive benefits for PTS. For mild/moderate and severe PTS, rivaroxaban provided the highest benefits in preventing PTS (89.3% and 85.6%, respectively). Edoxaban demonstrated a better prophylactic effect on PTS (Villalta score > 5), while rivaroxaban displayed a better effect against mild/moderate (Villalta score 5 to 14) and severe PTS (Villalta score ≥ 15, ulceration).
Sections du résumé
BACKGROUND
BACKGROUND
Postthrombotic syndrome (PTS) has a major impact on the quality of life after deep venous thrombosis (DVT). From clinical practice and related trials, anticoagulants show potential for reducing the occurrence and alleviating the symptoms of PTS.
METHODS
METHODS
A systematic review and Bayesian network meta-analysis (NMA) were conducted by combing the literature from the databases of MEDLINE, Embase, Web of Science, Cochrane Libraries, and ClinicalTrials, through a variety of medical subject headings (Mesh) and PTS keywords. With regard to PTS prophylaxis, all anticoagulant-related randomized controlled trials (RCTs) and observational studies were assessed. The network model was conducted through the R software, and further comparisons were conducted using the Bayesian hierarchical random effects model. The odds ratio (OR) and the corresponding 95% CI were calculated for analysis.
RESULTS
RESULTS
Data from two RCTs and nine non-randomized studies meeting the selection criteria were included in the Bayesian analysis model, which incorporated seven anticoagulants. Edoxaban (OR: 0.42, 95% CI: 0.18-1.0) and rivaroxaban (OR: 0.54, 95% CI: 0.38-0.76) were significantly more effective than warfarin in the prevention of PTS (Villalta score ≥ 5). A subgroup analysis based on the severity of PTS showed that rivaroxaban was more effective than warfarin, with OR: 0.59, 95% CI: 0.41-0.84 (Villalta score 5 to 14) and OR: 0.48, 95% CI: 0.22-0.9 (Villalta score ≥ 15, ulceration), respectively. Edoxaban had the highest probability (80.1%) of providing preventive benefits for PTS. For mild/moderate and severe PTS, rivaroxaban provided the highest benefits in preventing PTS (89.3% and 85.6%, respectively).
CONCLUSION
CONCLUSIONS
Edoxaban demonstrated a better prophylactic effect on PTS (Villalta score > 5), while rivaroxaban displayed a better effect against mild/moderate (Villalta score 5 to 14) and severe PTS (Villalta score ≥ 15, ulceration).
Identifiants
pubmed: 38068502
pii: jcm12237450
doi: 10.3390/jcm12237450
pmc: PMC10706867
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Références
Thromb Res. 2022 May;213:119-124
pubmed: 35344784
N Engl J Med. 2008 Nov 20;359(21):2195-207
pubmed: 18997196
J Am Heart Assoc. 2021 Jun;10(11):e018973
pubmed: 34032127
Lancet. 1997 Mar 15;349(9054):759-62
pubmed: 9074574
Eur J Vasc Endovasc Surg. 1996 Nov;12(4):487-91; discussion 491-2
pubmed: 8980442
J Thromb Haemost. 2021 Oct;19(10):2495-2503
pubmed: 34255420
Thromb Haemost. 2016 Sep 27;116(4):733-8
pubmed: 27583311
Intern Emerg Med. 2020 Apr;15(3):447-452
pubmed: 31667697
Lancet Haematol. 2020 Jan;7(1):e40-e49
pubmed: 31786086
J Vasc Surg. 2000 Jun;31(6):1307-12
pubmed: 10842165
N Engl J Med. 2009 Dec 10;361(24):2342-52
pubmed: 19966341
J Vasc Surg Venous Lymphat Disord. 2014 Apr;2(2):123-30
pubmed: 26993176
Blood. 2009 Nov 19;114(21):4624-31
pubmed: 19741190
J Thromb Haemost. 2015 Mar;13(3):398-408
pubmed: 25495610
Arch Intern Med. 2001 Sep 24;161(17):2105-9
pubmed: 11570939
Vasa. 2016;45(2):133-40
pubmed: 27058799
J Thromb Haemost. 2009 May;7(5):879-83
pubmed: 19175497
Thromb Res. 2011 Feb;127 Suppl 3:S89-92
pubmed: 21262451
Circ Cardiovasc Imaging. 2021 Mar;14(3):e011898
pubmed: 33724049
Environ Toxicol Pharmacol. 2017 Sep;54:93-98
pubmed: 28704755
Circulation. 2014 Oct 28;130(18):1636-61
pubmed: 25246013
Circulation. 2014 Feb 18;129(7):764-72
pubmed: 24344086
Br J Haematol. 2009 May;145(3):286-95
pubmed: 19222476
Ann Intern Med. 1996 Jul 1;125(1):1-7
pubmed: 8644983
Syst Rev. 2017 Dec 19;6(1):263
pubmed: 29258593
Thromb Res. 2018 Apr;164:110-115
pubmed: 29126608
J Thromb Haemost. 2006 Apr;4(4):734-42
pubmed: 16634738
Lancet. 2012 Jan 7;379(9810):31-8
pubmed: 22172244
Thromb Res. 2017 Sep;157:46-48
pubmed: 28692839
Int J Cardiol. 2022 Jan 1;346:93-99
pubmed: 34780886
Am J Med. 2011 Aug;124(8):756-65
pubmed: 21787905
Sci Rep. 2019 Apr 30;9(1):6690
pubmed: 31040359
J Thromb Haemost. 2022 May;20(5):1056-1066
pubmed: 35243742
Surgery. 2019 Dec;166(6):1076-1083
pubmed: 31277885
Thromb Res. 2018 Mar;163:6-11
pubmed: 29324334
N Engl J Med. 2018 Feb 15;378(7):615-624
pubmed: 29231094
Am J Med. 2009 Aug;122(8):762-769.e3
pubmed: 19635277
Blood Rev. 2002 Sep;16(3):155-65
pubmed: 12163001
Vascul Pharmacol. 2020 Jan;124:106608
pubmed: 31678199
Thromb Res. 2018 Apr;164:100-109
pubmed: 28844444
Int Angiol. 2012 Apr;31(2):169-75
pubmed: 22466983
Hematology Am Soc Hematol Educ Program. 2016 Dec 2;2016(1):413-418
pubmed: 27913509
J Thromb Haemost. 2017 Feb;15(2):230-241
pubmed: 27860129
Phlebology. 2012 Mar;27 Suppl 1:130-5
pubmed: 22312079
J Clin Epidemiol. 2016 Aug;76:193-9
pubmed: 26939929
Thromb Res. 2016 Jan;137:3-10
pubmed: 26654719
Arch Intern Med. 2004 Jan 12;164(1):17-26
pubmed: 14718318
Thromb Haemost. 2022 Aug;122(8):1255-1264
pubmed: 34852380
Thromb Res. 2018 Dec;172:86-93
pubmed: 30391776
J Vasc Surg. 1999 Aug;30(2):283-92
pubmed: 10436448
N Engl J Med. 2009 Apr 30;360(18):1851-61
pubmed: 19329822
Angiology. 2022 Aug;73(7):649-654
pubmed: 34989625
Lancet Haematol. 2016 Feb;3(2):e64-71
pubmed: 26853645
Stat Med. 2010 Mar 30;29(7-8):932-44
pubmed: 20213715
N Engl J Med. 2017 Dec 7;377(23):2240-2252
pubmed: 29211671
J Vasc Surg. 2011 Feb;53(2):500-9
pubmed: 21129900
Eur J Vasc Endovasc Surg. 2004 Nov;28(5):484-93
pubmed: 15465369
Thromb Res. 2015 Mar;135(3):497-501
pubmed: 25575413
Eur J Vasc Endovasc Surg. 2021 Jan;61(1):9-82
pubmed: 33334670
J Vasc Surg. 2008 Oct;48(4):953-9
pubmed: 18639417
J Thromb Haemost. 2009 Apr;7(4):582-7
pubmed: 19175493
Am J Med. 2010 Jan;123(1):60-5
pubmed: 20102993
World J Surg. 1996 Jun;20(5):521-6; discussion 526-7
pubmed: 8661630
Blood. 2014 Sep 18;124(12):1968-75
pubmed: 24963045