Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in nephrotic syndrome patients: a retrospective study
Abstract Background Nephrotic syndrome (NS) is associated with an increased risk of venous thromboembolism (VTE). Anticoagulants are widely used in the prevention of VTE in NS patients. The use of direct oral anticoagulants (DOACs) has not been studied intensively in NS patients. The aim of this stu...
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BMC
2025-01-01
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| Series: | Thrombosis Journal |
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| Online Access: | https://doi.org/10.1186/s12959-025-00685-0 |
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| author | Ahmed El-Bardissy Mohamed Nabil Elshafei Hebatullah Abdelgawad Rana Mekkawi Asma Eltahir AbdulMoqeeth Mohammed Ashour AM Hazem Elewa |
| author_facet | Ahmed El-Bardissy Mohamed Nabil Elshafei Hebatullah Abdelgawad Rana Mekkawi Asma Eltahir AbdulMoqeeth Mohammed Ashour AM Hazem Elewa |
| author_sort | Ahmed El-Bardissy |
| collection | DOAJ |
| description | Abstract Background Nephrotic syndrome (NS) is associated with an increased risk of venous thromboembolism (VTE). Anticoagulants are widely used in the prevention of VTE in NS patients. The use of direct oral anticoagulants (DOACs) has not been studied intensively in NS patients. The aim of this study is to determine the efficacy and safety of DOACs compared to warfarin for prophylactic anticoagulation in patients with nephrotic syndrome. Methods Retrospective analysis conducted in a tertiary hospital-based ambulatory anticoagulation clinic between 01/07/2016 and 29/11/2021. We aimed to evaluate the incidence of VTE, major bleeding, and non-major bleeding in both the DOACs and warfarin groups. Results Fifty-seven patients were recruited, 31 patients were prescribed warfarin (54.4%), and 26 were on DOAC (45.6%). Two patients in the DOAC group developed VTE, while no subjects in the warfarin group developed VTE, however, the difference was not statistically significance (p = 0.2). Nine out of 31 patients in the warfarin group developed non-major bleeding compared to three patients in the DOAC group (p = 0.02). One patient developed major bleeding in each group DOAC group 1 (15.4%), warfarin 1 (12.9%) (p = 1.00). There was no statistically significant difference in major bleeding between DOAC and warfarin groups (p = 1.00). Conclusion In patients with NS, preliminary evidence suggests that DOACs have comparable efficacy as compared to warfarin when used as prophylaxis. Additionally, DOACs result in lower incidences of non-major bleeding. However, further studies are indicated to confirm the superiority of DOACs over warfarin. |
| format | Article |
| id | doaj-art-a7a8bbae1d76493ba17702c7fcfb7b0b |
| institution | Kabale University |
| issn | 1477-9560 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj-art-a7a8bbae1d76493ba17702c7fcfb7b0b2025-02-02T12:37:33ZengBMCThrombosis Journal1477-95602025-01-012311610.1186/s12959-025-00685-0Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in nephrotic syndrome patients: a retrospective studyAhmed El-Bardissy0Mohamed Nabil Elshafei1Hebatullah Abdelgawad2Rana MekkawiAsma Eltahir3AbdulMoqeeth Mohammed4Ashour AM5Hazem Elewa6Clinical Pharmacy Department, Hamad Medical Corporation (HMC)Clinical Pharmacy Department, Hamad Medical Corporation (HMC)Clinical Pharmacy Department, Hamad Medical Corporation (HMC)Clinical Pharmacy Department, Hamad Medical Corporation (HMC)Ambulatory Internal Medicine Clinic, College of Medicine QU, Clinical Medicine WCM, Lead Anticoagulation clinic HGH, Co-Lead Resident MOP HGHDivision of Nephrology, Department of Medicine, Hamad Medical CorporationCollege of Pharmacy, QU Health, Qatar UniversityAbstract Background Nephrotic syndrome (NS) is associated with an increased risk of venous thromboembolism (VTE). Anticoagulants are widely used in the prevention of VTE in NS patients. The use of direct oral anticoagulants (DOACs) has not been studied intensively in NS patients. The aim of this study is to determine the efficacy and safety of DOACs compared to warfarin for prophylactic anticoagulation in patients with nephrotic syndrome. Methods Retrospective analysis conducted in a tertiary hospital-based ambulatory anticoagulation clinic between 01/07/2016 and 29/11/2021. We aimed to evaluate the incidence of VTE, major bleeding, and non-major bleeding in both the DOACs and warfarin groups. Results Fifty-seven patients were recruited, 31 patients were prescribed warfarin (54.4%), and 26 were on DOAC (45.6%). Two patients in the DOAC group developed VTE, while no subjects in the warfarin group developed VTE, however, the difference was not statistically significance (p = 0.2). Nine out of 31 patients in the warfarin group developed non-major bleeding compared to three patients in the DOAC group (p = 0.02). One patient developed major bleeding in each group DOAC group 1 (15.4%), warfarin 1 (12.9%) (p = 1.00). There was no statistically significant difference in major bleeding between DOAC and warfarin groups (p = 1.00). Conclusion In patients with NS, preliminary evidence suggests that DOACs have comparable efficacy as compared to warfarin when used as prophylaxis. Additionally, DOACs result in lower incidences of non-major bleeding. However, further studies are indicated to confirm the superiority of DOACs over warfarin.https://doi.org/10.1186/s12959-025-00685-0Nephrotic syndromeWarfarinDOACRetrospective study |
| spellingShingle | Ahmed El-Bardissy Mohamed Nabil Elshafei Hebatullah Abdelgawad Rana Mekkawi Asma Eltahir AbdulMoqeeth Mohammed Ashour AM Hazem Elewa Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in nephrotic syndrome patients: a retrospective study Thrombosis Journal Nephrotic syndrome Warfarin DOAC Retrospective study |
| title | Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in nephrotic syndrome patients: a retrospective study |
| title_full | Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in nephrotic syndrome patients: a retrospective study |
| title_fullStr | Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in nephrotic syndrome patients: a retrospective study |
| title_full_unstemmed | Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in nephrotic syndrome patients: a retrospective study |
| title_short | Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in nephrotic syndrome patients: a retrospective study |
| title_sort | direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in nephrotic syndrome patients a retrospective study |
| topic | Nephrotic syndrome Warfarin DOAC Retrospective study |
| url | https://doi.org/10.1186/s12959-025-00685-0 |
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