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Lobastov K.V.

Kafedra obshcheĭ khirurgii lechebnogo fakul'teta GOU VPO RGMU Roszdrava, Moskva

Contemporary approaches to determine the duration of anticoagulant therapy for venous thromboembolism

Authors:

Lobastov K.V.

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Journal: Pirogov Russian Journal of Surgery. 2019;(5): 94‑103

DOI: 10.17116/hirurgia201905194

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CONTEMPORARY APPROACHES TO DETERMINE THE DURATION OF ANTICOAGULANT THERAPY FOR VENOUS THROMBOEMBOLISM
CONTEMPORARY APPROACHES TO DETERMINE THE DURATION OF ANTICOAGULANT THERAPY FOR VENOUS THROMBOEMBOLISM

To cite this article:

Lobastov KV. Contemporary approaches to determine the duration of anticoagulant therapy for venous thromboembolism. Pirogov Russian Journal of Surgery. 2019;(5):94‑103. (In Russ.)
https://doi.org/10.17116/hirurgia201905194

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The review is devoted to the issue of optimal duration of anticoagulant therapy for venous thromboembolic complications (VTEC) using oral anticoagulants (OAC). These drugs are characterized by higher safety in comparison with vitamin K antagonists and make it possible to increase the duration of treatment for not only spontaneous thrombosis (with high risk of recurrence), but also thrombosis provoked by minor persistent and transient risk factors of VTEC. Efficacy and safety of prolonged treatment of VTEC using OAC was analyzed. Different classifications of primary thrombotic episode depending on risk of subsequent recurrence are presented. Moreover, scales for individual assessment of risk of recurrent thrombosis after anticoagulant therapy cancellation and risk of bleeding in case of continued treatment are given. Outcomes of long-term administration of rivaroxaban for VTEC are analyzed. It was concluded that OAC are safe for prolonged management of primary thrombotic episode. However, overall duration of treatment should be determined considering individual balance of benefits and risks.

Keywords:

venous thrombosis
venous thrombosis
pulmonary embolism
pulmonary embolism
anticoagulant therapy
anticoagulant therapy
duration
duration
oral anticoagulants
oral anticoagulants

Authors:

Lobastov K.V.

Kafedra obshcheĭ khirurgii lechebnogo fakul'teta GOU VPO RGMU Roszdrava, Moskva

List of references:

  1. Oger E. Incidence of venous thromboembolism: a community-based study in Western France. EPI-GETBP Study Group. Groupe d’Etude de la Thrombose de Bretagne Occidentale. Journal of Thrombosis and Haemostasis. 2000;83(5):657-660.
  2. Naess IA, Christiansen SC, Romundstad P, et al. Incidence and mortality of venous thrombosis: a population-based study. Journal of thrombosis and haemostasis: JTH. 2007;5(4):692-699. https://doi.org/10.1111/j.1538-7836.2007.02450.x
  3. White RH. The epidemiology of venous thromboembolism. Circulation. 2003;107(23 Suppl 1):14-18. https://doi.org/10.1161/01.CIR.0000078468.11849.66
  4. Cushman M, Tsai AW, White RH, et al. Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology. The American journal of medicine. 2004;117(1):19-25. https://doi.org/10.1016/j.amjmed.2004.01.018
  5. Nordstrom M, Lindblad B, Bergqvist D, Kjellstrom T. A prospective study of the incidence of deep-vein thrombosis within a defined urban population. Journal of internal medicine. 1992;232(2):155-160.
  6. Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ, 3rd. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med. 1998;158(6):585-593.
  7. Cohen AT, Agnelli G, Anderson FA, et al. Europe V.T.E.I.A.G.i., Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost. 2007;98(4):756-764.
  8. Obshchaya zabolevaemost’ vsego naseleniya Rossii v 2012 godu. Statisticheskie materialy, Chast’ II. 2013;[cited 2018 03.05]. (In Russ.). Available from: http://www.rosminzdrav.ru/documents/8029-statisticheskaya-informatsiya-2012
  9. Zabolevaemost’ vsego naseleniya Rossii v 2014 godu. Statisticheskie materialy, Chast’ II. 2015. [cited 2018 03.05]. (In Russ.). Available from: https://www.rosminzdrav.ru/documents/9479-statisticheskaya-informatsiya-za-2014
  10. Zabolevaemost’ vsego naseleniya Rossii v 2016 godu. Statisticheskie materialy Chast’ II. 2017. (In Russ.). Available from: https://www.rosminzdrav.ru/ministry/61/22/stranitsa-979/statisticheskie-i-informatsionnye-materialy/statisticheskiy-sbornik-2016-god
  11. Heit JA, Silverstein MD, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ, 3rd. Predictors of survival after deep vein thrombosis and pulmonary embolism: a population-based, cohort study. Arch Intern Med. 1999;159(5):445-453.
  12. Kahn SR, Galanaud JP, Vedantham S, Ginsberg JS. Guidance for the prevention and treatment of the post-thrombotic syndrome. J Thromb Thrombolysis. 2016;41(1):144-153. https://doi.org/10.1007/s11239-015-1312-5
  13. Prandoni P, Lensing AW, Cogo A, et al. The long-term clinical course of acute deep venous thrombosis. Ann Intern Med. 1996;125(1):1-7.
  14. Prandoni P, Noventa F, Ghirarduzzi A, et al. The risk of recurrent venous thromboembolism after discontinuing anticoagulation in patients with acute proximal deep vein thrombosis or pulmonary embolism. A prospective cohort study in 1,626 patients. Haematologica. 2007;92(2):199-205.
  15. Young L, Ockelford P, Milne D, et al. Post-treatment residual thrombus increases the risk of recurrent deep vein thrombosis and mortality. Journal of Thrombosis and Haemostasis. 2006;4(9):1919-1924. https://doi.org/10.1111/j.1538-7836.2006.02120.x
  16. Lindmarker P, Schulman S. The risk of ipsilateral versus contralateral recurrent deep vein thrombosis in the leg. Journal of internal medicine. 2000;247(5):601-606.
  17. Prandoni P, Lensing AW, Prins MH, et al. Residual venous thrombosis as a predictive factor of recurrent venous thromboembolism. Annals of internal medicine. 2002;137(12):955-960.
  18. Bokeriya LA, Zatevakhin II, Kirienko AI, et al. Rossiiskie klinicheskie rekomendatsii po diagnostike, lecheniyu i profilaktike venoznykh tromboembolicheskikh oslozhnenii (VTEO). Flebologiya. 2015;9(4-2):51-52. (In Russ.)
  19. Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuunemann HJ. Executive summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012. 141(2 Suppl):7S-47S. https://doi.org/10.1378/chest.1412S3
  20. Kearon C, Akl EA, Ornelas J, et al. Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report. Chest. 2016;149(2):315-352. https://doi.org/10.1016/j.chest.2015.11.026
  21. Ageno W, Squizzato A, Wells PS, Buller HR, Johnson G. The diagnosis of symptomatic recurrent pulmonary embolism and deep vein thrombosis: guidance from the SSC of the ISTH. J Thromb Haemost. 2013;11(8):1597-1602. https://doi.org/10.1111/jth.12301
  22. Egermayer P. The effects of heparin and oral anticoagulants on thrombus propagation and prevention of the postphlebitic syndrome: a critical review of the literature. Prog Cardiovasc Dis. 2001;44(1):69-80. https://doi.org/10.1053/pcad.2001.24684
  23. Pacouret G, Alison D, Pottier JM, Bertrand P, Charbonnier B. Free-floating thrombus and embolic risk in patients with angiographically confirmed proximal deep venous thrombosis. A prospective study. Arch Inter Med. 1997;157(3):305-308
  24. Partsch H. Therapy of deep vein thrombosis with low molecular weight heparin, leg compression and immediate ambulation. Vasa. 2001;30(3):195-204. https://doi.org/10.1024/0301-1526.30.3.195
  25. Limone BL, Hernandez AV, Michalak D, Bookhart BK, Coleman CI. Timing of recurrent venous thromboembolism early after the index event: a metaanalysis of randomized controlled trials. Thromb Res. 2013;132(4):420-426. https://doi.org/10.1016/j.thromres.2013.08.003
  26. Ageno W, Gallus AS, Wittkowsky A, Crowther M, Hylek EM, Palareti G. Oral anticoagulant therapy Antithrombotic Therapy and Prevention of Thrombosis. 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012;141(2 Suppl):e44S-e88S. https://doi.org/10.1378/chest.11-2292
  27. Salmeron Febres, L.M., Cuenca Manteca, J., Direct Oral Anticoagulants in the Treatment of Venous Thromboembolic Disease. Ann Vasc Surg. 2017;42:337-350. https://doi.org/10.1016/j.avsg.2017.01.010
  28. Investigators E, Bauersachs R, Berkowitz SD, Brenner B, Buller HR, Decousus H, Gallus AS, Lensing AW, Misselwitz F, Prins MH, Raskob GE, Segers A, Verhamme P, Wells P, Agnelli G, Bounameaux H, Cohen A, Davidson BL, Piovella F. Schellong S. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med. 2010;363(26):2499-2510. https://doi.org/10.1056/NEJMoa1007903
  29. Investigators E-P, Buller HR, Prins MH, et al. Oral rivaroxaban for the treatment of symptomatic pulmonary embolism. N Engl J Med. 2012. 366(14): p. 1287-97. https://doi.org/10.1056/NEJMoa1113572
  30. Agnelli G, Buller HR, Cohen A, et al. Investigators A Oral apixaban for the treatment of acute venous thromboembolism. N Engl J Med. 2013;369(9):799-808. https://doi.org/10.1056/NEJMoa1302507
  31. Ageno W, Mantovani LG, Haas S, et al. Safety and effectiveness of oral rivaroxaban versus standard anticoagulation for the treatment of symptomatic deep-vein thrombosis (XALIA): an international, prospective, non-interventional study. The Lancet Haematology. 2014;3(1);e12-e21. https://doi.org/10.1016/S2352-3026(15)00257-4
  32. Beyer-Westendorf J, Lensing AW, Arya R, et al. Choosing wisely: The impact of patient selection on efficacy and safety outcomes in the EINSTEIN-DVT/PE and AMPLIFY trials. Thromb Res. 2017;149:29-37. https://doi.org/10.1016/j.thromres.2016.11.014
  33. Geldhof V, Vandenbriele C, Verhamme P, Vanassche T. Venous thromboembolism in the elderly: efficacy and safety of non-VKA oral anticoagulants. Thromb J. 2014;12:21. https://doi.org/10.1186/1477-9560-12-21
  34. Prins MH, Lensing AW, Bauersachs R, et al. Oral rivaroxaban versus standard therapy for the treatment of symptomatic venous thromboembolism: a pooled analysis of the EINSTEIN-DVT and PE randomized studies. Thrombosis journal. 2013;11(1):21. https://doi.org/10.1186/1477-9560-11-21
  35. Eikelboom JW, Connolly SJ, Bosch J, et al. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. New England Journal of Medicine. 2017;377(14):1319-1330.
  36. Young AM, Marshall A, Thirlwal J, et al. Comparison of an Oral Factor Xa Inhibitor With Low Molecular Weight Heparin in Patients With Cancer With Venous Thromboembolism: Results of a Randomized Trial (SELECT-D). J Clin Oncol. 2018;36(20):2017-2023. https://doi.org/10.1200/JCO.2018.78.8034
  37. Boutitie F, Pinede L, Schulman S, et al. Influence of preceding length of anticoagulant treatment and initial presentation of venous thromboembolism on risk of recurrence after stopping treatment: analysis of individual participants’ data from seven trials. BMJ. 2011;342: d3036. https://doi.org/10.1136/bmj.d3036
  38. Middeldorp S, Prins MH, Hutten BA. Duration of treatment with vitamin K antagonists in symptomatic venous thromboembolism. Cochrane Database Syst Rev. 2014;(8):CD001367. https://doi.org/10.1002/14651858.CD001367.pub3
  39. Carrier M, Le Gal G, Wells PS, Rodger MA. Systematic review: case-fatality rates of recurrent venous thromboembolism and major bleeding events among patients treated for venous thromboembolism. Annals of internal medicine. 2010;152(9):578-589. https://doi.org/10.7326/0003-4819-152-9-201005040-00008
  40. Simes J, Becattini C, Agnelli G, et al. Aspirin for the prevention of recurrent venous thromboembolism: the INSPIRE collaboration. Circulation. 2014;130(13):1062-1071. https://doi.org/10.1161/CIRCULATIONAHA.114.008828
  41. Schulman S, Kearon C, Kakkar AK, Schellong S, Eriksson H, Baanstra D, Kvamme AM, Friedman J, Mismetti P, Goldhaber SZ, Investigators R-MT, Investigators R-ST. Extended use of dabigatran, warfarin, or placebo in venous thromboembolism. N Engl J Med. 2013;368(8):709-718. https://doi.org/10.1056/NEJMoa1113697
  42. Agnelli G, Buller HR, Cohen A, Curto M, Gallus AS, Johnson M, Porcari A, Raskob GE, Weitz JI, Investigators P-E. Apixaban for extended treatment of venous thromboembolism. N Engl J Med. 2013;368(8):699-708. https://doi.org/10.1056/NEJMoa1207541
  43. Weitz JI, Lensing AWA, Prins MH, et al. Rivaroxaban or Aspirin for Extended Treatment of Venous Thromboembolism. New England Journal of Medicine. 2017;376(13):1211-1222. https://doi.org/10.1056/NEJMoa1700518
  44. Prins MH, Lensing AWA, Prandoni P, et al. Risk of recurrent venous thromboembolism according to baseline risk factor profiles. Blood Adv. 2018;2(7):788-796. https://doi.org/10.1182/bloodadvances.2018017160
  45. Iorio A, Kearon C, Filippucci E, et al. Risk of recurrence after a first episode of symptomatic venous thromboembolism provoked by a transient risk factor: a systematic review. Arch Intern Med. 2010;170(19):1710-1716. https://doi.org/10.1001/archinternmed.2010.367
  46. Palareti G. Recurrent venous thromboembolism: what is the risk and how to prevent it. Scientifica (Cairo). 2012;2012:391734. https://doi.org/10.6064/2012/391734
  47. Zhu T, Martinez I, Emmerich J. Venous thromboembolism: risk factors for recurrence. Arterioscler Thromb Vasc Biol. 2009;29(3):298-310. https://doi.org/10.1161/ATVBAHA.108.182428
  48. Mearns ES, Coleman CI, Patel D, et al. Index clinical manifestation of venous thromboembolism predicts early recurrence type and frequency: a meta-analysis of randomized controlled trials. J Thromb Haemost. 2015;13(6):1043-1052. https://doi.org/10.1111/jth.12914
  49. Douketis J, Tosetto A, Marcucci M,et al. Patient-level metaanalysis: effect of measurement timing, threshold, and patient age on ability of D-dimer testing to assess recurrence risk after unprovoked venous thromboembolism. Ann Intern Med. 2010;153(8):523-531. https://doi.org/10.7326/0003-4819-153-8-201010190-00009
  50. Kearon C, Spencer FA, O’Keeffe D, et al. Ginsberg JS, Spadafora L, Julian JA, Investigators DdODS. D-dimer testing to select patients with a first unprovoked venous thromboembolism who can stop anticoagulant therapy: a cohort study. Ann Intern Med. 2015;162(1):27-34. https://doi.org/10.7326/M14-1275
  51. Donadini MP, Ageno W, Antonucci E, Cosmi B, Kovacs MJ, Le Gal G, Ockelford P, Poli D, Prandoni P, Rodger M, Saccullo G, Siragusa S, Young L, Bonzini M, Caprioli M, Dentali F, Iorio A, Douketis JD. Prognostic significance of residual venous obstruction in patients with treated unprovoked deep vein thrombosis: a patient-level meta-analysis. Thromb Haemost. 2014;111(1):172-179. https://doi.org/10.1160/TH13-04-0336
  52. Lobastov K, Ryzhkin V, Vorontsova A, Schastlivtsev I, Barinov V, Laberko L, Rodoman G. Electrical calf muscle stimulation in patients with post-thrombotic syndrome and residual venous obstruction after anticoagulation therapy. Int Angiol, 2018;37(5):400-410. https://doi.org/10.23736/S0392-9590.18.03997-4
  53. Eichinger S, Heinze G, Jandeck LM, Kyrle PA. Risk assessment of recurrence in patients with unprovoked deep vein thrombosis or pulmonary embolism: the Vienna prediction model. Circulation. 2010;121(14):1630-1636. https://doi.org/10.1161/CIRCULATIONAHA.109.925214
  54. Franco Moreno AI, Garcia Navarro MJ, Ortiz Sanchez J, et al. A risk score for prediction of recurrence in patients with unprovoked venous thromboembolism (DAMOVES). Eur J Intern Med. 2016;29:59-64. https://doi.org/10.1016/j.ejim.2015.12.010
  55. Tosetto A, Iorio A, Marcucci M, et al. Predicting disease recurrence in patients with previous unprovoked venous thromboembolism: a proposed prediction score (DASH). J Thromb Haemost. 2012;10(6):1019-1025. https://doi.org/10.1111/j.1538-7836.2012.04735.x
  56. van Hylckama Vlieg A, Baglin CA, Luddington R, et al. The risk of a first and a recurrent venous thrombosis associated with an elevated D-dimer level and an elevated thrombin potential: results of the THE-VTE study. J Thromb Haemost. 2015;13(9):1642-1652. https://doi.org/10.1111/jth.13043
  57. Rodger MA, Kahn SR, Wells PS, et al. Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy. CMAJ. 2008;179(5):417-426. https://doi.org/10.1503/cmaj.080493
  58. Rodger MA, Le Gal G, Anderson DR, et al. Validating the HERDOO2 rule to guide treatment duration for women with unprovoked venous thrombosis: multinational prospective cohort management study. BMJ. 2017;356:j1065. https://doi.org/10.1136/bmj.j1065
  59. Coleman CI, Turpie AGG, Bunz TJ, Beyer-Westendorf J, Baker WL. Impact of Prolonged Anticoagulation with Rivaroxaban on Provoked Venous Thromboembolism Recurrence: IMPROVE-VTE. Am J Med. 2018. https://doi.org/10.1016/j.amjmed.2018.11.040

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