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©The Author(s) 2023.
World J Gastroenterol. Sep 7, 2023; 29(33): 4962-4974
Published online Sep 7, 2023. doi: 10.3748/wjg.v29.i33.4962
Published online Sep 7, 2023. doi: 10.3748/wjg.v29.i33.4962
Table 3 Characteristics of studies on cirrhotic patients with portal vein thrombosis treated with direct oral anticoagulants
Study | Population | Aim of study | Doses and duration | Outcomes | Adverse events | Ref. |
Retrospective | Cirrhotic, CP A/B/C; any indication (incl. PVT); subgroup with PVT: Riva or Api (n = 4) vs Enoxa or VKA (n = 3) | Efficacy and safety of DOACs vs traditional AC in cirrhosis | Riva 15 mg OD +/- 20 mg OD load; Api 5 mg BID +/- 10 mg BID load 10.6 mo (mean) | Recurrent thrombosis: DOACs (n = 1); Trad AC (n = 1) | Total bleeding events were similar in the two groups (with lesser major bleeding in the DOACs group) | Hum et al[87], 2017 |
Retrospective | Cirrhotic, CP A/BAny indication (incl. PVT); subgroup with PVT: Riva or Api (n = 12) vs LMWH or Warf (n = 6) | Compare the bleeding rates in cirrhotic patients | Riva 20 mg OD; Api 5 mg BID 10.6 mo (mean) | No statistical difference between therapeutic and prophylactic dosing between groups | Similar rates of major and minor bleeding in the two groups | Intagliata et al[89], 2016 |
Retrospective | Both cirrhotic and non, CP A/B; any indication (incl. PVT); subgroup with cirrhosis and PVT: Riva, Api or Dabi (n = 22) | Indication for starting or switching to DOACs and report short-term efficacy and safety | Cirrhotic: Different doses 9.6 mo (mean) | Cirrhotic: recurrent PVT (n = 1, 4.5%) | Cirrhotic group any indication: Major bleeding (n = 1), minor bleeding (n = 4) | De Gottardi et al[88], 2017 |
Retrospective | Both cirrhotic and non, CP A/B/C; non-malignant PVT; Edo (n = 4), Api (n = 3), Riva (n = 2), Dabi (n = 1) vs traditional AC (n = 12), no AC (n = 39) | Efficacy and safety of AC in non-malignant PVT | Edo 30/60 mg OD, Api 5 mg BID, Riva 10 mg OD, Dabi 110 mg BID 9.2 mo (median) | Favourable outcomes with DOACs: Regression/resolution 20%; stability/non-progression 80% | Portal hypertensive gastropathy bleeding | Scheiner et al[41], 2018 |
Retrospective | Cirrhotic, CP A/B; non-malignant PVT; Edo (n = 20) vs Warf (n = 30) (following 2 wk Danaparoid) | Compare the efficacy and safety of Edo and Warf for treatment of chronic PVT in cirrhotic patients | Edo 60 mg OD, (if CrCl > 50; n = 4) or Edo 30 mg OD (if CrCl < 50; n = 16) 6 mo (max) | Edo group had more complete resolution and less PVT progression than Warf group | Major GI bleeding: Edo (n = 3; 7%); Warf (n = 2; 15%) | Nagaoki et al[91], 2018 |
Prospective | Cirrhotic, CP A; chronic PTV; Riva (n = 26), Dabi (n = 14) vs no AC (n = 40) | Compare the efficacy and safety of DOACs and no AC in chronic PVT in cirrhotic patients | Riva 20 mg OD; Dabi 150 mg BID; 6 mo (max) | Recanalization rate with DOACs 28.2% (statistically higher) and improvement of liver function | No statistically significant difference between the DOACs and the control group in bleeding events | Ai et al[92], 2020 |
Prospective | Cirrhotic, CP A/B/C; non-malignant PVT; TIPS + AC (n = 197, 18 Riva) vs AC only (n = 63, 4 Riva) vs TIPS only (n = 88) vs nothing (n = 48) | Compare the management using a wait-and-see strategy, AC, and TIPS to treat PVT in cirrhosis | Riva 10 mg OD; 21.0 mo (median) | Recanalization: 0% with Riva only (all with PVT and SMV thrombosis), 100% with Riva + TIPS | Major bleeding events: AC only (n = 14); TIPS+AC (n = 30) | Lv et al[93], 2021 |
- Citation: Monaco G, Bucherini L, Stefanini B, Piscaglia F, Foschi FG, Ielasi L. Direct oral anticoagulants for the treatment of splanchnic vein thrombosis: A state of art. World J Gastroenterol 2023; 29(33): 4962-4974
- URL: https://www.wjgnet.com/1007-9327/full/v29/i33/4962.htm
- DOI: https://dx.doi.org/10.3748/wjg.v29.i33.4962