Direct oral anticoagulants in treatment of cerebral venous thrombosis

Detalhes bibliográficos
Autor(a) principal: Bose, Gauruv
Data de Publicação: 2021
Outros Autores: Graveline, Justin, Yogendrakumar, Vignan, Shorr, Risa, Fergusson, Dean A, Le Gal, Gregoire, Coutinho, Jonathan, Mendonça, Marcelo, Viana-Baptista, Miguel, Nagel, Simon, Dowlatshahi, Dar
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/112283
Resumo: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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spelling Direct oral anticoagulants in treatment of cerebral venous thrombosisa systematic review© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVES: Current guidelines do not recommend direct oral anticoagulants (DOACs) to treat cerebral venous thrombosis (CVT) despite their benefits over standard therapy. We performed a systematic review to summarise the published experience of DOAC therapy in CVT. DATA SOURCES: MEDLINE, Embase and COCHRANE databases up to 18 November 2020. ELIGIBILITY CRITERIA: All published articles of patients with CVT treated with DOAC were included. Studies without follow-up information were excluded. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers screened articles and extracted data. A risk of bias analysis was performed. PRIMARY AND SECONDARY OUTCOME MEASURES: Safety data included mortality, intracranial haemorrhage (ICH) or other adverse events. Efficacy data included recurrent CVT, recanalisation rates and disability by modified Rankin Scales (mRS). RESULTS: 33 studies met inclusion criteria. One randomised controlled trial, 5 observational cohorts and 27 case series or studies reported 279 patients treated with DOAC for CVT: 41% dabigatran, 47% rivaroxaban, 10% apixaban and 2% edoxaban, in addition to 315 patients treated with standard therapy. The observational cohorts showed a similar risk of death in DOAC and standard therapy arms (RR 2.12, 95% CI 0.29 to 15.59). New ICH was reported in 2 (0.7%) DOAC-treated patients and recurrent CVT occurred in 4 (1.5%). A favourable mRS between 0 and 2 was reported in 94% of DOAC-treated patients, more likely than standard therapy in observational cohorts (RR 1.13, 95% CI 1.02 to 1.25). CONCLUSION: The evidence for DOAC use in CVT is limited although suggests sufficient safety and efficacy despite variability in timing and dose of treatment. This systematic review highlights that further rigorous trials are needed to validate these findings and to determine optimal treatment regimens.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNBose, GauruvGraveline, JustinYogendrakumar, VignanShorr, RisaFergusson, Dean ALe Gal, GregoireCoutinho, JonathanMendonça, MarceloViana-Baptista, MiguelNagel, SimonDowlatshahi, Dar2021-02-23T00:04:14Z2021-02-162021-02-16T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/112283eng2044-6055PURE: 28245873https://doi.org/10.1136/bmjopen-2020-040212info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:55:57Zoai:run.unl.pt:10362/112283Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:42:09.354069Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Direct oral anticoagulants in treatment of cerebral venous thrombosis
a systematic review
title Direct oral anticoagulants in treatment of cerebral venous thrombosis
spellingShingle Direct oral anticoagulants in treatment of cerebral venous thrombosis
Bose, Gauruv
title_short Direct oral anticoagulants in treatment of cerebral venous thrombosis
title_full Direct oral anticoagulants in treatment of cerebral venous thrombosis
title_fullStr Direct oral anticoagulants in treatment of cerebral venous thrombosis
title_full_unstemmed Direct oral anticoagulants in treatment of cerebral venous thrombosis
title_sort Direct oral anticoagulants in treatment of cerebral venous thrombosis
author Bose, Gauruv
author_facet Bose, Gauruv
Graveline, Justin
Yogendrakumar, Vignan
Shorr, Risa
Fergusson, Dean A
Le Gal, Gregoire
Coutinho, Jonathan
Mendonça, Marcelo
Viana-Baptista, Miguel
Nagel, Simon
Dowlatshahi, Dar
author_role author
author2 Graveline, Justin
Yogendrakumar, Vignan
Shorr, Risa
Fergusson, Dean A
Le Gal, Gregoire
Coutinho, Jonathan
Mendonça, Marcelo
Viana-Baptista, Miguel
Nagel, Simon
Dowlatshahi, Dar
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Bose, Gauruv
Graveline, Justin
Yogendrakumar, Vignan
Shorr, Risa
Fergusson, Dean A
Le Gal, Gregoire
Coutinho, Jonathan
Mendonça, Marcelo
Viana-Baptista, Miguel
Nagel, Simon
Dowlatshahi, Dar
description © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
publishDate 2021
dc.date.none.fl_str_mv 2021-02-23T00:04:14Z
2021-02-16
2021-02-16T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/112283
url http://hdl.handle.net/10362/112283
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2044-6055
PURE: 28245873
https://doi.org/10.1136/bmjopen-2020-040212
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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