Direct Oral Anticoagulants Versus Traditional Anticoagulation in Cirrhotic Patients with Portal Vein Thrombosis: Updated Systematic Review

Background This systematic review aimed to evaluate the comparative effectiveness and safety of direct oral anticoagulants (DOACs) compared to traditional anticoagulation (vitamin K antagonists or low-molecular-weight heparins) in cirrhotic patients with portal vein thrombosis (PVT). Methods We cond...

Full description

Saved in:
Bibliographic Details
Main Authors: Xiulin Xiao M.S., Wengen Zhu M.D., Qixin Dai M.D.
Format: Article
Language:English
Published: SAGE Publishing 2024-11-01
Series:Clinical and Applied Thrombosis/Hemostasis
Online Access:https://doi.org/10.1177/10760296241303758
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850157619992330240
author Xiulin Xiao M.S.
Wengen Zhu M.D.
Qixin Dai M.D.
author_facet Xiulin Xiao M.S.
Wengen Zhu M.D.
Qixin Dai M.D.
author_sort Xiulin Xiao M.S.
collection DOAJ
description Background This systematic review aimed to evaluate the comparative effectiveness and safety of direct oral anticoagulants (DOACs) compared to traditional anticoagulation (vitamin K antagonists or low-molecular-weight heparins) in cirrhotic patients with portal vein thrombosis (PVT). Methods We conducted a literature search in PubMed and Embase databases up to May 2024. Studies were selected according to the PICOS criteria, focusing on cirrhotic patients with PVT treated with DOACs (dabigatran, rivaroxaban, apixaban, or edoxaban) compared to traditional anticoagulation. Results Our systematic review included four observational studies conducted in Japan, China, and the United States, involving a total of 223 patients with cirrhosis and PVT. The included studies collectively suggested that anticoagulation therapy, including DOACs, was associated with improved recanalization rates and reduced progression of PVT in patients with liver cirrhosis, without a significant increase in bleeding complications. Specifically, edoxaban demonstrated superior effectiveness in reducing PVT volume compared to traditional anticoagulation, while maintaining a favorable safety profile. Conclusion DOACs may provide a promising therapeutic option for PVT in cirrhotic patients. Further research is needed to confirm the potential benefits and risks of DOACs in this population.
format Article
id doaj-art-74cb8b2f0ce0421cbae3f974e56fa902
institution OA Journals
issn 1938-2723
language English
publishDate 2024-11-01
publisher SAGE Publishing
record_format Article
series Clinical and Applied Thrombosis/Hemostasis
spelling doaj-art-74cb8b2f0ce0421cbae3f974e56fa9022025-08-20T02:24:07ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232024-11-013010.1177/10760296241303758Direct Oral Anticoagulants Versus Traditional Anticoagulation in Cirrhotic Patients with Portal Vein Thrombosis: Updated Systematic ReviewXiulin Xiao M.S.0Wengen Zhu M.D.1Qixin Dai M.D.2 Department of Hepatopancreatobiliary Surgery, Ganzhou People's Hospital, Ganzhou, Jiangxi, China Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China Department of Hepatopancreatobiliary Surgery, Ganzhou People's Hospital, Ganzhou, Jiangxi, ChinaBackground This systematic review aimed to evaluate the comparative effectiveness and safety of direct oral anticoagulants (DOACs) compared to traditional anticoagulation (vitamin K antagonists or low-molecular-weight heparins) in cirrhotic patients with portal vein thrombosis (PVT). Methods We conducted a literature search in PubMed and Embase databases up to May 2024. Studies were selected according to the PICOS criteria, focusing on cirrhotic patients with PVT treated with DOACs (dabigatran, rivaroxaban, apixaban, or edoxaban) compared to traditional anticoagulation. Results Our systematic review included four observational studies conducted in Japan, China, and the United States, involving a total of 223 patients with cirrhosis and PVT. The included studies collectively suggested that anticoagulation therapy, including DOACs, was associated with improved recanalization rates and reduced progression of PVT in patients with liver cirrhosis, without a significant increase in bleeding complications. Specifically, edoxaban demonstrated superior effectiveness in reducing PVT volume compared to traditional anticoagulation, while maintaining a favorable safety profile. Conclusion DOACs may provide a promising therapeutic option for PVT in cirrhotic patients. Further research is needed to confirm the potential benefits and risks of DOACs in this population.https://doi.org/10.1177/10760296241303758
spellingShingle Xiulin Xiao M.S.
Wengen Zhu M.D.
Qixin Dai M.D.
Direct Oral Anticoagulants Versus Traditional Anticoagulation in Cirrhotic Patients with Portal Vein Thrombosis: Updated Systematic Review
Clinical and Applied Thrombosis/Hemostasis
title Direct Oral Anticoagulants Versus Traditional Anticoagulation in Cirrhotic Patients with Portal Vein Thrombosis: Updated Systematic Review
title_full Direct Oral Anticoagulants Versus Traditional Anticoagulation in Cirrhotic Patients with Portal Vein Thrombosis: Updated Systematic Review
title_fullStr Direct Oral Anticoagulants Versus Traditional Anticoagulation in Cirrhotic Patients with Portal Vein Thrombosis: Updated Systematic Review
title_full_unstemmed Direct Oral Anticoagulants Versus Traditional Anticoagulation in Cirrhotic Patients with Portal Vein Thrombosis: Updated Systematic Review
title_short Direct Oral Anticoagulants Versus Traditional Anticoagulation in Cirrhotic Patients with Portal Vein Thrombosis: Updated Systematic Review
title_sort direct oral anticoagulants versus traditional anticoagulation in cirrhotic patients with portal vein thrombosis updated systematic review
url https://doi.org/10.1177/10760296241303758
work_keys_str_mv AT xiulinxiaoms directoralanticoagulantsversustraditionalanticoagulationincirrhoticpatientswithportalveinthrombosisupdatedsystematicreview
AT wengenzhumd directoralanticoagulantsversustraditionalanticoagulationincirrhoticpatientswithportalveinthrombosisupdatedsystematicreview
AT qixindaimd directoralanticoagulantsversustraditionalanticoagulationincirrhoticpatientswithportalveinthrombosisupdatedsystematicreview