Efficiency and safety of direct oral anticoagulants in onco-associated venous thromboembolic complications: meta-analysis

The work aimed to analyze the efficiency and safety of direct oral anticoagulants in treating onco-associated venous thromboembolic complications. Materials and methods . A meta-analysis of randomized controlled trials was performed in accordance with the guidelines “Preferred reporting parameters for systematic reviews and meta-analyses.” Results . Data from four randomized controlled trials were used to perform the meta-analysis. Direct oral anticoagulants reduce the relative risk of recurrent venous thromboembolic complications compared with dalteparin by 38% (relative ratio [RR]=0.62; 95% confidence interval [CI] [0.43–0.91]; p =0.01) and reduce statistically significantly the risk of deep vein thrombosis by 40% (RR=0.60; 95% CI [0.40–0.90]; p =0.01). In the effectiveness of prevention of repeated pulmonary embolism, the compared technologies are comparable (RR=0.89; 95% CI [0.52–1.51]; p =0.66). A safety meta-analysis suggests that direct oral anticoagulants are comparable in safety compared with dalteparin, in terms of major bleeding incidences (RR=1.33; 95% CI [0.84–2.11]; p =0.23) and in relation to gastrointestinal bleeding development (RR=1.91; 95% CI [0.96–3.82]; p =0.07). Direct oral anticoagulants increased the incidence of clinically significant minor bleeding (RR=1.58; 95% CI [1.11–2.24]; p =0.01).