Direct-acting oral anticoagulants vs warfarin in relation to risk of gastrointestinal bleeding: A systematic review and meta-analysis of randomized controlled trials
Annals of Gastroenterology Aug 25, 2021
Aloysius MM, Perisetti A, Goyal H, et al. - A lower risk of fatal gastrointestinal bleeding (GIB) was found to be associated with the use of direct-acting oral anticoagulants (DOACs) vs warfarin; this was particularly true in patients aged <60 years and those with poor coagulation control. However, a comparable GIB risk was conferred by warfarin and DOACs, except for rivaroxaban and dabigatran.
A systematic review and meta-analysis was conducted.
Randomized clinical trials (RCTs) that compared warfarin and DOACs for several indications (atrial fibrillation, thromboembolism, insertion of mechanical heart valves) were included.
Any GIB event was the primary endpoint.
14 RCTs with 87,407 participants (DOACs n = 46,223, warfarin control n = 41,184) were analyzed.
A higher risk of any GIB was noted with rivaroxaban and dabigatran vs warfarin.
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