Novel Oral Anticoagulants Are as Effective as Vitamin K Antagonists for Patients with Acute VTE

Novel oral anticoagulants are promising alternatives to vitamin K antagonists for treating patients with acute venous thromboembolism (VTE). In a meta-analysis of nine randomized, controlled trials that involved >16,000 patients, investigators compared the effectiveness of novel oral anticoagulants (factor Xa inhibitors, rivaroxaban [Xarelto] and apixaban, and direct thrombin inhibitors, dabigatran [Pradaxa] and ximelagatran) and conventional oral vitamin K antagonists (e.g., warfarin). Vitamin K antagonists always were preceded by initial heparin therapy, whereas pretreatment with heparin was variable before the novel agents.

For recurrent acute VTE and all-cause mortality, no significant differences were found among any of the novel antico…