Comparison of Direct Oral Anticoagulants for Treatment of Cerebral Venous Thrombosis – A Retrospective Cohort Study

Limited available evidence comparing DOACs with warfarin suggests efficacy and safety of DOACs for CVT. We aimed to evaluate whether a specific DOAC is preferred for the treatment of CVT. This retrospective cohort study included adult patients with CVTs between September 2018 and September 2022 trea...

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Main Authors: Paul Phan PharmD, Lisa T. Hong PharmD, BCPS, APh, PNAP
Format: Article
Language:English
Published: SAGE Publishing 2025-01-01
Series:Clinical and Applied Thrombosis/Hemostasis
Online Access:https://doi.org/10.1177/10760296251316869
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author Paul Phan PharmD
Lisa T. Hong PharmD, BCPS, APh, PNAP
author_facet Paul Phan PharmD
Lisa T. Hong PharmD, BCPS, APh, PNAP
author_sort Paul Phan PharmD
collection DOAJ
description Limited available evidence comparing DOACs with warfarin suggests efficacy and safety of DOACs for CVT. We aimed to evaluate whether a specific DOAC is preferred for the treatment of CVT. This retrospective cohort study included adult patients with CVTs between September 2018 and September 2022 treated with a DOAC. The primary outcome was rate of partial or complete recanalization. Secondary outcomes included rate of recurrent VTE, CVT extension, major or clinically relevant non-major bleeding, and death within 180 days after DOAC initiation. Of 31 patients with CVT, 21 received apixaban, 7 received rivaroxaban, and 3 received dabigatran. Among those with repeat imaging, the primary composite outcome occurred in 100%, 80%, and 100% for each group, respectively (P = 0.34). One patient had extension of CVT while on apixaban and one patient had increased midline shift while on rivaroxaban. No other secondary outcomes were observed. There do not appear to be significant efficacy or safety differences between DOACs when used for CVT treatment, though larger studies are needed to validate these findings.
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spelling doaj-art-4d91b74908544e11b49710dbd46321da2025-01-29T14:03:25ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232025-01-013110.1177/10760296251316869Comparison of Direct Oral Anticoagulants for Treatment of Cerebral Venous Thrombosis – A Retrospective Cohort StudyPaul Phan PharmD0Lisa T. Hong PharmD, BCPS, APh, PNAP1 , Loma Linda, CA, USA , Loma Linda, CA, USALimited available evidence comparing DOACs with warfarin suggests efficacy and safety of DOACs for CVT. We aimed to evaluate whether a specific DOAC is preferred for the treatment of CVT. This retrospective cohort study included adult patients with CVTs between September 2018 and September 2022 treated with a DOAC. The primary outcome was rate of partial or complete recanalization. Secondary outcomes included rate of recurrent VTE, CVT extension, major or clinically relevant non-major bleeding, and death within 180 days after DOAC initiation. Of 31 patients with CVT, 21 received apixaban, 7 received rivaroxaban, and 3 received dabigatran. Among those with repeat imaging, the primary composite outcome occurred in 100%, 80%, and 100% for each group, respectively (P = 0.34). One patient had extension of CVT while on apixaban and one patient had increased midline shift while on rivaroxaban. No other secondary outcomes were observed. There do not appear to be significant efficacy or safety differences between DOACs when used for CVT treatment, though larger studies are needed to validate these findings.https://doi.org/10.1177/10760296251316869
spellingShingle Paul Phan PharmD
Lisa T. Hong PharmD, BCPS, APh, PNAP
Comparison of Direct Oral Anticoagulants for Treatment of Cerebral Venous Thrombosis – A Retrospective Cohort Study
Clinical and Applied Thrombosis/Hemostasis
title Comparison of Direct Oral Anticoagulants for Treatment of Cerebral Venous Thrombosis – A Retrospective Cohort Study
title_full Comparison of Direct Oral Anticoagulants for Treatment of Cerebral Venous Thrombosis – A Retrospective Cohort Study
title_fullStr Comparison of Direct Oral Anticoagulants for Treatment of Cerebral Venous Thrombosis – A Retrospective Cohort Study
title_full_unstemmed Comparison of Direct Oral Anticoagulants for Treatment of Cerebral Venous Thrombosis – A Retrospective Cohort Study
title_short Comparison of Direct Oral Anticoagulants for Treatment of Cerebral Venous Thrombosis – A Retrospective Cohort Study
title_sort comparison of direct oral anticoagulants for treatment of cerebral venous thrombosis a retrospective cohort study
url https://doi.org/10.1177/10760296251316869
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