Anticoagulation therapy patterns for acute treatment of venous thromboembolism in GARFIELD-VTE patients

Sylvia Haas; Walter Ageno; Jeffrey I Weitz; Samuel Z Goldhaber; Alexander G G Turpie; Shinya Goto; Pantep Angchaisuksiri; Joern Dalsgaard Nielsen; Gloria Kayani; Audrey Zaghdoun; Alfredo E Farjat; Sebastian Schellong; Henri Bounameaux; Lorenzo G Mantovani; Paolo Prandoni; Ajay K Kakkar

doi:10.1111/jth.14548

Anticoagulation therapy patterns for acute treatment of venous thromboembolism in GARFIELD-VTE patients

Sylvia Haas, Walter Ageno, Jeffrey I Weitz, Samuel Z Goldhaber, Alexander G G Turpie, Shinya Goto, Pantep Angchaisuksiri, Joern Dalsgaard Nielsen, Gloria Kayani, Audrey Zaghdoun, Alfredo E Farjat, Sebastian Schellong, Henri Bounameaux, Lorenzo G Mantovani, Paolo Prandoni, Ajay K Kakkar

Hjerteafd. Y

33 Citationer (Scopus)

Abstract

BACKGROUND: Parenteral anticoagulants and vitamin K antagonists (VKAs) have constituted the cornerstone of venous thromboembolism (VTE) treatment. Meanwhile, direct oral anticoagulants (DOACs) provide physicians with an alternative. The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE observes real-world treatment practices.

OBJECTIVES: Describe initial anticoagulation (AC) treatment patterns in VTE patients who received parenteral AC, VKAs, and/or DOACs within ±30 days of diagnosis.

METHODS: VTE patients were categorized into parenteral AC only, parenteral AC with transition to VKA, VKA only, parenteral AC with transition to DOAC, and DOAC only.

RESULTS: A total of 9647 patients were initiated on AC treatment alone. 4781 (49.6%) patients received DOACs ± parenteral ACs; 3187 (33.0%), VKA ± parenteral ACs; and 1679 (17.4%) parenteral ACs alone. Rivaroxaban was the most frequently used DOAC (79.4%). DOACs were more frequently used in North America/Australia (58.1%), Europe (52.2%), and Asia (47.6%) than in Latin America (29.7%) and the Middle East/South Africa (32.5%). In patients with suspected VTE, most received parenteral AC monotherapy (67.7%). Patients with deep vein thrombosis were more likely to receive DOACs alone than those with pulmonary embolism with or without deep vein thrombosis (36.2% vs 25.9%). Active cancer patients received parenteral AC alone (58.9%), with 25.5% receiving DOAC ± parenteral AC and 12.8% parenteral AC and VKA. A total of 46.5% of pregnant patients received parenteral AC monotherapy, 34.0% were treated with VKA ± parenteral AC, and 19.5% received a DOAC (± parenteral AC).

CONCLUSION: AC treatment patterns vary by patient population, geographic region and site of VTE. Guidelines for AC therapy are not always adhered to.

Originalsprog	Engelsk
Tidsskrift	Journal of thrombosis and haemostasis : JTH
Vol/bind	17
Udgave nummer	10
Sider (fra-til)	1694-1706
Antal sider	13
ISSN	1538-7933
DOI	https://doi.org/10.1111/jth.14548
Status	Udgivet - okt. 2019

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10.1111/jth.14548

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Haas, S., Ageno, W., Weitz, J. I., Goldhaber, S. Z., Turpie, A. G. G., Goto, S., Angchaisuksiri, P., Dalsgaard Nielsen, J., Kayani, G., Zaghdoun, A., Farjat, A. E., Schellong, S., Bounameaux, H., Mantovani, L. G., Prandoni, P., & Kakkar, A. K. (2019). Anticoagulation therapy patterns for acute treatment of venous thromboembolism in GARFIELD-VTE patients. Journal of thrombosis and haemostasis : JTH, 17(10), 1694-1706. https://doi.org/10.1111/jth.14548

Haas, S, Ageno, W, Weitz, JI, Goldhaber, SZ, Turpie, AGG, Goto, S, Angchaisuksiri, P, Dalsgaard Nielsen, J, Kayani, G, Zaghdoun, A, Farjat, AE, Schellong, S, Bounameaux, H, Mantovani, LG, Prandoni, P & Kakkar, AK 2019, 'Anticoagulation therapy patterns for acute treatment of venous thromboembolism in GARFIELD-VTE patients', Journal of thrombosis and haemostasis : JTH, bind 17, nr. 10, s. 1694-1706. https://doi.org/10.1111/jth.14548

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title = "Anticoagulation therapy patterns for acute treatment of venous thromboembolism in GARFIELD-VTE patients",

abstract = "BACKGROUND: Parenteral anticoagulants and vitamin K antagonists (VKAs) have constituted the cornerstone of venous thromboembolism (VTE) treatment. Meanwhile, direct oral anticoagulants (DOACs) provide physicians with an alternative. The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE observes real-world treatment practices.OBJECTIVES: Describe initial anticoagulation (AC) treatment patterns in VTE patients who received parenteral AC, VKAs, and/or DOACs within ±30 days of diagnosis.METHODS: VTE patients were categorized into parenteral AC only, parenteral AC with transition to VKA, VKA only, parenteral AC with transition to DOAC, and DOAC only.RESULTS: A total of 9647 patients were initiated on AC treatment alone. 4781 (49.6%) patients received DOACs ± parenteral ACs; 3187 (33.0%), VKA ± parenteral ACs; and 1679 (17.4%) parenteral ACs alone. Rivaroxaban was the most frequently used DOAC (79.4%). DOACs were more frequently used in North America/Australia (58.1%), Europe (52.2%), and Asia (47.6%) than in Latin America (29.7%) and the Middle East/South Africa (32.5%). In patients with suspected VTE, most received parenteral AC monotherapy (67.7%). Patients with deep vein thrombosis were more likely to receive DOACs alone than those with pulmonary embolism with or without deep vein thrombosis (36.2% vs 25.9%). Active cancer patients received parenteral AC alone (58.9%), with 25.5% receiving DOAC ± parenteral AC and 12.8% parenteral AC and VKA. A total of 46.5% of pregnant patients received parenteral AC monotherapy, 34.0% were treated with VKA ± parenteral AC, and 19.5% received a DOAC (± parenteral AC).CONCLUSION: AC treatment patterns vary by patient population, geographic region and site of VTE. Guidelines for AC therapy are not always adhered to.",

keywords = "Aged, Aged, 80 and over, Anticoagulants/administration & dosage, Blood Coagulation/drug effects, Drug Utilization/trends, Female, Guideline Adherence/trends, Healthcare Disparities/trends, Humans, Male, Middle Aged, Practice Guidelines as Topic, Practice Patterns, Physicians'/trends, Pregnancy, Pulmonary Embolism/blood, Registries, Time Factors, Treatment Outcome, Venous Thromboembolism/blood, Venous Thrombosis/blood",

author = "Sylvia Haas and Walter Ageno and Weitz, {Jeffrey I} and Goldhaber, {Samuel Z} and Turpie, {Alexander G G} and Shinya Goto and Pantep Angchaisuksiri and {Dalsgaard Nielsen}, Joern and Gloria Kayani and Audrey Zaghdoun and Farjat, {Alfredo E} and Sebastian Schellong and Henri Bounameaux and Mantovani, {Lorenzo G} and Paolo Prandoni and Kakkar, {Ajay K}",

note = "{\textcopyright} 2019 International Society on Thrombosis and Haemostasis.",

year = "2019",

month = oct,

doi = "10.1111/jth.14548",

language = "English",

volume = "17",

pages = "1694--1706",

journal = "Journal of thrombosis and haemostasis : JTH",

issn = "1538-7933",

publisher = "Elsevier BV",

number = "10",

}

TY - JOUR

T1 - Anticoagulation therapy patterns for acute treatment of venous thromboembolism in GARFIELD-VTE patients

AU - Haas, Sylvia

AU - Ageno, Walter

AU - Weitz, Jeffrey I

AU - Goldhaber, Samuel Z

AU - Turpie, Alexander G G

AU - Goto, Shinya

AU - Angchaisuksiri, Pantep

AU - Dalsgaard Nielsen, Joern

AU - Kayani, Gloria

AU - Zaghdoun, Audrey

AU - Farjat, Alfredo E

AU - Schellong, Sebastian

AU - Bounameaux, Henri

AU - Mantovani, Lorenzo G

AU - Prandoni, Paolo

AU - Kakkar, Ajay K

PY - 2019/10

Y1 - 2019/10

N2 - BACKGROUND: Parenteral anticoagulants and vitamin K antagonists (VKAs) have constituted the cornerstone of venous thromboembolism (VTE) treatment. Meanwhile, direct oral anticoagulants (DOACs) provide physicians with an alternative. The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE observes real-world treatment practices.OBJECTIVES: Describe initial anticoagulation (AC) treatment patterns in VTE patients who received parenteral AC, VKAs, and/or DOACs within ±30 days of diagnosis.METHODS: VTE patients were categorized into parenteral AC only, parenteral AC with transition to VKA, VKA only, parenteral AC with transition to DOAC, and DOAC only.RESULTS: A total of 9647 patients were initiated on AC treatment alone. 4781 (49.6%) patients received DOACs ± parenteral ACs; 3187 (33.0%), VKA ± parenteral ACs; and 1679 (17.4%) parenteral ACs alone. Rivaroxaban was the most frequently used DOAC (79.4%). DOACs were more frequently used in North America/Australia (58.1%), Europe (52.2%), and Asia (47.6%) than in Latin America (29.7%) and the Middle East/South Africa (32.5%). In patients with suspected VTE, most received parenteral AC monotherapy (67.7%). Patients with deep vein thrombosis were more likely to receive DOACs alone than those with pulmonary embolism with or without deep vein thrombosis (36.2% vs 25.9%). Active cancer patients received parenteral AC alone (58.9%), with 25.5% receiving DOAC ± parenteral AC and 12.8% parenteral AC and VKA. A total of 46.5% of pregnant patients received parenteral AC monotherapy, 34.0% were treated with VKA ± parenteral AC, and 19.5% received a DOAC (± parenteral AC).CONCLUSION: AC treatment patterns vary by patient population, geographic region and site of VTE. Guidelines for AC therapy are not always adhered to.

AB - BACKGROUND: Parenteral anticoagulants and vitamin K antagonists (VKAs) have constituted the cornerstone of venous thromboembolism (VTE) treatment. Meanwhile, direct oral anticoagulants (DOACs) provide physicians with an alternative. The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE observes real-world treatment practices.OBJECTIVES: Describe initial anticoagulation (AC) treatment patterns in VTE patients who received parenteral AC, VKAs, and/or DOACs within ±30 days of diagnosis.METHODS: VTE patients were categorized into parenteral AC only, parenteral AC with transition to VKA, VKA only, parenteral AC with transition to DOAC, and DOAC only.RESULTS: A total of 9647 patients were initiated on AC treatment alone. 4781 (49.6%) patients received DOACs ± parenteral ACs; 3187 (33.0%), VKA ± parenteral ACs; and 1679 (17.4%) parenteral ACs alone. Rivaroxaban was the most frequently used DOAC (79.4%). DOACs were more frequently used in North America/Australia (58.1%), Europe (52.2%), and Asia (47.6%) than in Latin America (29.7%) and the Middle East/South Africa (32.5%). In patients with suspected VTE, most received parenteral AC monotherapy (67.7%). Patients with deep vein thrombosis were more likely to receive DOACs alone than those with pulmonary embolism with or without deep vein thrombosis (36.2% vs 25.9%). Active cancer patients received parenteral AC alone (58.9%), with 25.5% receiving DOAC ± parenteral AC and 12.8% parenteral AC and VKA. A total of 46.5% of pregnant patients received parenteral AC monotherapy, 34.0% were treated with VKA ± parenteral AC, and 19.5% received a DOAC (± parenteral AC).CONCLUSION: AC treatment patterns vary by patient population, geographic region and site of VTE. Guidelines for AC therapy are not always adhered to.

KW - Aged

KW - Aged, 80 and over

KW - Anticoagulants/administration & dosage

KW - Blood Coagulation/drug effects

KW - Drug Utilization/trends

KW - Female

KW - Guideline Adherence/trends

KW - Healthcare Disparities/trends

KW - Humans

KW - Male

KW - Middle Aged

KW - Practice Guidelines as Topic

KW - Practice Patterns, Physicians'/trends

KW - Pregnancy

KW - Pulmonary Embolism/blood

KW - Registries

KW - Time Factors

KW - Treatment Outcome

KW - Venous Thromboembolism/blood

KW - Venous Thrombosis/blood

U2 - 10.1111/jth.14548

DO - 10.1111/jth.14548

M3 - Journal article

C2 - 31220403

SN - 1538-7933

VL - 17

SP - 1694

EP - 1706

JO - Journal of thrombosis and haemostasis : JTH

JF - Journal of thrombosis and haemostasis : JTH

IS - 10

ER -

Anticoagulation therapy patterns for acute treatment of venous thromboembolism in GARFIELD-VTE patients

Abstract

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