Direct oral anticoagulants for the treatment of splanchnic vein thrombosis: A state of art

Table 1 Characteristics of studies on non-cirrhotic patients with portal vein thrombosis treated with direct oral anticoagulants

Study	Population	Outcomes	Adverse events	Ref.
Prospective	Non-cirrhotic, atypical sites (including PVT); Riva and Api for PVT (n = 16) vs enoxa for PVT (n = 13)	Riva and Apixaban are effective and safe in patients with venous thrombosis of atypical locations	No major difference in bleeding rate	Janczak et al[40], 2018
Retrospective	Non-malignant PVT, both cirrhotic and non-cirrhotic; Edo (n = 4), Api (n = 3), Riva (n = 2), Dabi (n = 1) vs traditional AC (n = 12), no AC (n = 39)	Favourable outcomes with DOACs with regression/resolution of thrombus in 20% of patients and stability or nonprogression in 80%	One bleeding episode in DOACs	Scheiner et al[41], 2018
Retrospective	Non-cirrhotic PVT; Riva (n = 65), Api (n = 20), Dabi (n = 8) vs Warf (n = 108), Enoxa (n = 70), Fondap (n = 2)	Resolution rate: Dabi (75%), Api (65%), Riva (65%), Enoxa (57%), Warf (31%); Recanalization rates are higher in DOACs compared to Warf but similar to Enoxa	Less major bleeding incidence in DOACs	Naymagon et al[42], 2020
Retrospective	IBD-associated PVT; DOACs (n = 23) vs Warf (n = 22), Enoxa (n = 13)	Resolution rate: DOACs (96%), Warf (55%); DOACs group needed a shorter course of anticoagulation (median 3.9 vs 8.5)	N/A	Naymagon et al[43] 2021
Retrospective	Intraabdominal surgery < 3 mo prior to PVT diagnosis; DOACs (n = 35) vs Warf (n = 31), Enoxa (n = 29), no AC (n = 12)	Complete resolution rate: DOACs (77%), Enoxa (69%), Warf (45%), no AC (17%)	N/A	Naymagon et al[44], 2021
Retrospective	PVT with/without cirrhosis; DOACs (n = 13; 8 non-cirrhotic) vs Warf (n = 20; 15 non cirrotic)	Treatment failure: DOACs (n = 0); Warf (n = 4)	Major bleedings: DOACs: n=0; VKA: n=1	Ilcewicz et al[45], 2021
Prospective	SVT without cirrhosis; Riva 15 BID for 3 wk + Riva 20 mg OD for 3 mo (n = 100)	Recanalization > 80% at 3 mo (47% complete)	2 major bleeding; 2 SVT recurrence	Ageno et al[46], 2022

AC: Anticoagulation; Api: Apixaban; BID: Twice daily; Dabi: Dabigatran; DOACs: Direct oral anticoagulants; Edo: Edoxaban; Enoxa: Enoxaparin; Fondap: Fondaparinux; IBD: Inflammatory bowel disease; OD: Once daily; PVT: Portal vein thrombosis; Riva: Rivaroxaban; SVT: Splanchnic vein thrombosis; VKA: Vitamin K antagonists; Warf: Warfarin.