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For many years, unfractionated heparin (UFH) followed by vitamin K antagonists was the standard treatment for patients with deep venous thrombosis or pulmonary embolism. More recently, low-molecular-weight heparin (LMWH) combined with vitamin K antagonists has become the most common choice, but other options include fondaparinux plus a vitamin K antagonist; edoxaban (submitted to the FDA, but not yet approved) or dabigatran (Pradaxa) combined with LMWH; or rivaroxaban (Xarelto), apixaban (Eliquis), or LMWH alone.
In a systematic review, researchers examined the safety and efficacy of these treatment strategies in 45 randomized controlled trials (durations, generally 3–6 months) with nearly 45,000 patients. Network meta-analysis techniques we…