venous thrombosis - antithrombotics
- all type of patients trial results systematic overview and meta-analysis
Main characteristics of the included studies
Trial |
Treatments |
Patients |
Methods |
Bratt et al , 1985
|
Dalteparin Intravenousv (ajusted) for >=5 Days, 120 U/kg BID
versus
unfractionated heparin intravenous APPTx1.7-3.5
|
|
follow-up 23 Months (mean)
n=25/29
|
Holm et al , 1986
|
Dalteparin Subcutaneous twice daily ajusted for 7 Days, 57-107 U/kg BID
versus
unfractionated heparin subcutaneous twice daily 16000-30000 U
|
|
follow-up Hospital Stay
n=29/27
|
Faivre et al , 1988
|
Minoctoparine (CY222) Subcutaneous twice daily for 10 Days,155 U/kg BID
versus
unfractionated heparin subcutaneous twice daily APPTx2-3
|
|
follow-up 10 Days
n=33/37
|
Bratt et al, 1990
|
Dalteparin Subcutaneous twice daily ajusted for >= 5 Days, 120 U/kg BID
versus
unfractionated heparin intravenous APPTx2-4
|
|
follow-up Hospital stay
n=60/60
|
Collaborative European Multicentre, 1991
|
Nadroparin Subcutaneous twice daily for 10 Days, 90 U/kg BID
versus
unfractionated heparin intravenous APPTx1.5-2
|
|
follow-up 12 Weeks
n=70/66
|
Prandoni et al , 1992
|
Nadroparin Subcutaneous twice daily for >=0 Days, 90 U/kg BID
versus
unfractionated heparin intravenous APPTx1.5-2
|
|
follow-up 6 Months
n=85/85
|
Lopaciuk et al , 1992
|
Nadroparin Subcutaneous twice daily for 10 Days, 92 U/kg BID
versus
unfractionated heparin subcutaneous twice daily APPTx1.5-2.5
|
|
follow-up 3 Months
n=74/75
|
Hull et al , 1992
|
Tinzaparin Subcutaneous once daily for >= Days, 175 U/kg BID
versus
unfractionated heparin intravenous APPTx2-3
|
|
follow-up 3 Months
n=213/219
|
Simonneau et al , 1993
|
Enoxaparin Subcutaneous twice daily for 0 Days, 100 U/kg BID
versus
unfractionated heparin intravenous APPTx1.5-2.5
|
|
follow-up 3 Months
n=67/67
|
Lindmarker et al , 1993
|
Dalteparin Subcutaneous once daily for >= 5 Days, 200 U/kg BID
versus
unfractionated heparin intravenous APPTx1.5-3
|
|
follow-up 6 Months
n=101/103
|
Charbonnier, 1998
|
Once daily nadroparin 20,500 (AXa IU/ml)continued for at least 5 days
versus
twice daily
nadroparin 10,250 (AXa IU/ml)continued for at least 5 days
|
patients with acute symptomatic proximal DVT in popliteal vein or above
documented by venography
|
follow-up
n=316/335
Parallel groups
double blind
Europe
|
Holmstr�m, 1992
|
once daily dalteparin 200 U (anti-FXa)/kg for at least 5 days
versus
twice daily dalteparin 100
U (anti-FXa)/kg for at least 5 days
|
Patients with a first occurence of DVT in the lower limb, confirmed with phlebographytio
|
follow-up
n=50/51
Parallel groups
open
Sweden
|
Merli, 2001
|
enoxaparin 1.5 mg/kg body weight
once daily
versus
S.c. enoxaparin at fixed dosages of 1.0 mg/kg of body weight twice daily
|
patients with a symptomatic lower-extremity DVT confirmed by venography or ultrasonography (including patients with confirmed PE)
|
follow-up
n=298/312
Parallel groups
double blind
Europe, United States of America and Australia, image/pj
|
Partsch, 1996
|
Fragmin administered 200 IU/kg once daily for at least 7 days
versus
Fragmin 100 IU/kg twice daily for at least 7 days
|
patients presented with DVT extending into the iliofemoral segment diagnosed by duplex ultrasonographyA
|
follow-up
n=76/64
Parallel groups
NA
Austria
|
Siegbahn, 1989
|
Once daily logiparin 150 XaI U/kgp, imag
versus
twice daily logiparin 75 XaI U/kg
|
patients with a venographically confirmed episode of DVT
|
follow-up
n=10/10
Parallel groups
single blind
Sweden and Denmark
|
Levine, 1995
|
continuation for 2 months of warfarin adjusted INR value of 2.0 to 3.0
versus
Discontinue oral anticoagulant therapy (after 1 months)
|
|
follow-up 11 months after randomization.
n=-9/-9
Parallel groups
double blind
Canada, Italy
|
Schulman, 1995
|
6 months treatment with warfarin or dicoumarol adjusted for a target INR between 2.0 - 2.85
versus
1.5 months warfarin or dicoumarol adjusted for a target INR between 2.0 - 2.85
|
|
follow-up Two years after randomization
n=-9/-9
Parallel groups
open
Sweden
|
Kearon, 1999
|
Continuation of the oral anticoagulant therapy up to 24 months,
warfarin was adjusted to achieve
a target INR between 2.0 and 3.0.
versus
discontinuation (after 3 months)
|
|
follow-up
n=-9/-9
|
Agnelli, 2001
|
continuation for 9 additional months; warfarin or acenocoumarol adjusted to achieve a target INR between 2.0 and 3.0
versus
discontinuation (after 3 months months)
|
|
follow-up 33 months
n=-9/-9
Parallel groups
open
Italy
|
Pinede, 2001
|
Long course of therapy (6 months for proximal DVT and/or PE; 12 weeks for calf DVT) by fluindione adjusted for INR range of 2.0 to 3.0
versus
Short oral anticoagulant course (3 months for proximal DVT and/or PE; 6 weeks for isolated calf
DVT) by fluindione adjusted for INR range of 2.0 to 3.0
|
|
follow-up 15 months after randomization�
n=-9/-9
Parallel groups
open
France
|
Agnelli, 2003
|
continuation for 3 or 9 additionnal months of warfarin or other oral anticoagulant was adjusted to achieve a target INR between 2.0 and 3.0.
versus
discontinuation (after 3 months)
|
|
follow-up 33 months
n=-9/-9
Parallel groups
open
Italy
|
Kearon, 2004
|
continuation for 2 additionnal months of warfarin adjusted to achieve
a target INR between 2.0 and 3.0.
versus
discontinuation (after 1 months)
|
|
follow-up 11 months (after randomizatio)
n=-9/-9
Parallel groups
double blind
Canada, US
|
Boccalon, 2000
|
home treatment with sub-cutaneous injection of LMWH (dalteparin sodium, enoxaparin sodium or nadroparin calciumas
chosen by the attending physician) at the recommended dose followed by anticoagulant for 6months
versus
Sub-cutaneous injection of LMWH(dalteparin sodium, enoxaparin sodium or nadroparin calcium as chosen by attending physician) at the recommended dose followed by anticoagulant for 6 months initially in hospital for 10 +/- 2 days then at home
|
patienst with confirmed diagnosis (by ultrasonography or venography) of proximal DVT not more than 30 days before enrolment
|
follow-up 6 months
n=99/101
Parallel groups
NA
France
|
Chong, 2005
|
once daily sub-cutaneous injection of enoxaparin 1.5mg/kg for a minimum of 5 days plus 10mg
of warfarin for 3 months adjusted to achieve INR above 2 and within range accepted by the investigator
versus
5000 IU bolus of unfractionated heparin (UFH) for a minimum of 5 days plus 10mg warfarin
started on day 1 of the treatment for 3 months
|
patients with diagnosis of symptomatic lower extrimity DVT (proimal or distal) confirmed by either
contrast venography and/or ultrasonography, be suitable for treatment in an outpatient setting
|
follow-up 24 months
n=150/148
Parallel groups
open
Australia, New Zealand, Poland, South Africa
|
Daskalopoulos, 2005
|
home treatment with single sub- cutaneous injection of LMWH (tinzaparin sodium) in a weight adjusted dose (175
anti Xa IU/Kg) daily for 6 months
versus
Intravenous bolus of 5000IU UFH followed by intrvenous infusion of UFH for 5-7 days. APTT
was measured after 4 hours of the initiation of heparin administration and was repeated 6 hours thereafter
to reach the therapeutic range (ratio: 1.5-2.5). Oral an
|
patients with acute proximal DVT confirmed by colour duplex UScan not more than 1 week onset
|
follow-up
n=55/53
Parallel groups
open
Greece
|
Koopman, 1996
|
home treatment with twice daily injections of nadroparin at a dose adjusted for patient�s weight;
versus
UH (APTT adjusted dose, continuous intravenous infusion of 1250 IU per hour after initial
intravenous bolus of 5000 IU) in hospital.
|
patients with acute symptomatic proximal DVT proven by venography or duplex scan
|
follow-up 12 weeks
n=202/198
Parallel groups
open
The Netherlands, France, Italy, New Zealand Australia
|
Levine, 1996
|
home treatment by Sub-cutaneous enoxaparin 1 mg per kg body weight twice a day for at least 5 days
versus
UH (APTT adjusted dose, continuous intravenous infusion of 20,000 IU after initial intravenous
bolus of 5000 IU) in hospital for at least 5 days
|
patients with acute proximal DVT proven on venography or duplex scan
|
follow-up 90 days
n=247/253
Parallel groups
open
Canada
|
Ramacciotti, 2004
|
home treatment by once daily Subcutaneous injection of enoxaparin at a dose of 1.5 mg/kg for 5-10 days
versus
in hospital intravenous bolus injection of 5000 IU of UFH followed by intravenous 500 IU/kg/day adjusted to maintain an aPTT of 1.5-2.5 times the normal value for 5-10 days.
|
patienst with DVT symptoms for greater than or equal to 10 days and proximal lower limb DVT confirmed by duplex ultrasound or venography
|
follow-up
n=104/97
Parallel groups
open
Brazil
|
Merli (once daily vs UFH), 2001
|
Initial therapy with enoxaparin 1.5 mg/kg body weight
once daily
versus
Initial therapy with dose-adjusted intravenous
unfractionated heparin
|
patients with a symptomatic lower-extremity DVT confirmed by venography or ultrasonography (including patients with confirmed PE)
|
follow-up 3 months
n=298/290
Parallel groups
partialy blinded
Europe, United States of America and Australia, image/pj
|
Schulman, 1997
|
indefinite warfarin or dicoumarol adjusted for a target INR between 2.0 and 2.85
versus
6 months warfarin or dicoumarol adjusted for a target INR between 2.0 and 2.85
|
|
follow-up Four years after randomization
n=-9/-9
Parallel groups
open
Sweden
|
MATISSE, 2004
|
fondaparinux 7.5 mg subcutaneously once daily for at least 5 days and until vitamin K antagonists induced an INR greater than 2.0.
versus
enoxaparin, 1 mg/kg of body weight, subcutaneously twice daily for at least 5 days and until vitamin K antagonists induced an INR greater than 2.0.
|
patients with acute symptomatic deep venous thrombosis
|
follow-up 3 months
n=1098/1107
Parallel groups
double blind
international
|
THRIVE I, 0
|
oral ximelagatran (24, 36, 48 or 60 mg twice daily) for 2 weeks
versus
dalteparin and warfarin for 2 weeks
|
Patients with acute DVT
|
follow-up
n=-9/-9
|
Ott import�, 1998
|
anticoagulants (s.c. heparin followed by oral warfarin) (duration NA)
versus
s.c. saline followed by oral placebo tablets
|
|
follow-up
n=11/12
double blind
Denmark
|
Nielsen import�, 1994
|
heparin and phenprocoumon for 3 months
versus
phenylbutazone
|
|
follow-up
n=48/42
open
Denmark
|
Fiessinger , 2005
|
ximelagatran 36 mg twice daily
versus
subcutaneous enoxaparin, 1 mg/kg twice daily, for 5 to 20 days followed by warfarin adjusted to maintain an international normalized ratio of 2.0 to 3.0.
|
patients with acute deep vein thrombosis
|
follow-up
n=-9/-9
double blind
|
Krahenbuhl, 1979
|
subcutaneous sodic heparin 30 000 U daily (mean)
versus
intravenous sodic heparin 30 000 U daily (mean)
|
|
follow-up
n=23/25
|
Bentley, 1980
|
subcutaneous calcic heparin 37 000 U daily (mean)
versus
intravenous sodic heparin 36 800 U daily (mean)
|
|
follow-up
n=50/50
|
Andersson, 1982
|
subcutaneous sodic heparin 36 800 U daily (mean)
versus
intravenous sodic heparin 33 250 U daily (mean)
|
|
follow-up
n=72/69
|
Hull, 1986
|
subcutaneous sodic heparin 32 300 U daily (mean)
versus
intravenous sodic heparin 29 700 U daily (mean)
|
|
follow-up
n=57/58
|
Doyle, 1987
|
subcutaneous calcic heparin 29 200 U daily (mean)
versus
intravenous calcic heparin 29 600 U daily (mean)
|
|
follow-up
n=51/52
|
Walker, 1987
|
subcutaneous calcic heparin 29 375 U daily (mean)
versus
intravenous calcic heparin 24 384 U daily (mean)
|
|
follow-up
n=50/50
|
Lopaciuk, 3000
|
subcutaneous sodic heparin 34 400 U daily (mean)
versus
intravenous sodic heparin 37 000 U daily (mean)
|
|
follow-up
n=48/46
|
Pini, 1990
|
subcutaneous calcic heparin 33 800 U daily (mean)
versus
intravenous sodic heparin 31 700 U daily (mean)
|
|
follow-up
n=138/133
|
Pini, 1994
|
UFH, APTT 1.3�1.9 followed by Enoxaparin 4,000 IU qd
versus
UFH, APTT 1.3�1.9 followed by Warfarin target INR 2-3.5
|
patients with objective diagnosis of DVT by Venography (diagnosed by strain-gauge plethysmography plus D-dimer latex assay and confirmed by venography)
|
follow-up 9 mo
n=93/94
open
|
Das, 1996
|
UFH followed by Dalteparin 5,000 IU qd
versus
UFH followed by Warfarin target INR 2-3
|
patients with objective diagnosis of DVT by Venography
|
follow-up 3 mo
n=50/55
open
|
Gonzalez-Fajardo, 1999
|
LMWH, 4,000 IU bid followed by Enoxaparin 4,000 IU qd
versus
UFH followed by Warfarin target INR 2-3
|
patients with objective diagnosis of DVT by Venography
|
follow-up 9 mo
n=93/92
Parallel groups
open
|
Lopaciuk, 1999
|
LMWH, 85 UI/kg bid followed by Nadroparin 85 IU/kg qd
versus
LMWH, 85 UI/kg bid followed by Acenocoumarol target INR 2-3
|
patients with objective diagnosis of DVT by Venography
|
follow-up 9 mo
n=101/101
open
|
Veiga, 2000
|
UFH, APTT 1.5�2.0d followed by Enoxaparin 4,000 IU qd
versus
UFH, APTT 1.5�2.0d followed by Acenocoumarol target INR 2-3
|
patients with objective diagnosis of DVT by Venography
|
follow-up 6-9 mo
n=50/50
open
|
Lopez-Beret, 2001
|
LMWH, 1,025 IU/10 kg bid followed by Nadroparin 1,025 IU/10 kg bid
versus
LMWH, 1,025 IU/10 kg bid followed by Acenocoumarol target INR 2-3
|
patients with objective diagnosis of DVT by compression ultrasonography
|
follow-up 6-9 mo
n=81/77
open
|
Meyer, 2002
|
LMWH, 1.5 mg/kg qd followed by Enoxaparin 1.5 mg/Kg qd
versus
LMWH, 1.5 mg/kg qd followed by Warfarin target INR 2-3
|
patients with cancer and objective diagnosis of DVT by Venography/compression ultrasonography
|
follow-up 3 mo
n=71/58
open
|
Hull, 2002
|
LMWH, 175 IU/kg qd followed by Tinzaparin 175 IU/kg qd
versus
UFH 5 d, followed by UFH therapeutic APTT followed by Warfarin target INR 2-3
|
patients with objective diagnosis of DVT by Venography/compression ultrasonography
|
follow-up 9 mo
n=369/368
open
|
Deitcher, 2003
|
LMWH: 1a, 1 mg/kg q12h; 1b, 1 mg/kg qd12h followed by Enoxaparin 1a: 1 mg/kg qd; 1b: 1.5 mg/kg qd
versus
LMWH, 1 mg/kg q12h followed by Warfarin target INR 2-3
|
patients with objective diagnosis of DVT
|
follow-up 6 mo
n=51/30
open
|
Kakkar, 2003
|
LMWH, 115 IU/kg qd followed by Bemiparin 3,500 IU qd
versus
A: UFH, 30/40,000IU qd; B: LMWH, 115 IU/kg qd followed by Warfarin target INR 2-3
|
patients with objective diagnosis of DVT by Venography/compression ultrasonography
|
follow-up 3 mo
n=221/103
open
|
Lee, 2003
|
LMWH, 200 IU/kg qd followed by Dalteparin 150 IU/kg qd
versus
LMWH, 200 IU/kg qd followed by Warfarin target INR 2-3
|
patients with cancer and objective diagnosis of DVT by Venography/compression ultrasonography
|
follow-up 6 mo
n=336/336
open
|
Einstein-DVT Dose-Ranging Study, 2008
|
rivaroxaban 20, 30, or 40 mg once daily
versus
low-molecular-weight heparin followed by vitamin K antagonists
|
patients with deep vein thrombosis
|
follow-up
n=-9/-9
open
|
Botticelli DVT, 2008
NCT00252005
|
apixaban 5 mg twice-daily, 10 mg twice-daily, or 20 mg once-daily for 84-91 days
versus
low molecular weight heparin followed by vitamin K antagonists
|
patients with symptomatic deep vein thrombosis
|
follow-up
n=358/118
Parallel groups
open
|
Gonz�lez-Fajardo, 2008
|
long-term anticoagulant treatment with enoxaparin during at least 3 months
versus
long-term anticoagulant treatment with coumarin during at least 3 months
|
patients with symptomatic, unilateral, first-episode DVT
|
follow-up 1y, 5y
n=85/80
Parallel groups
open, blind assessment
Spain
|
VanGogh DVT, 2007
NCT00067093
|
subcutaneous idraparinux (2.5 mg once weekly)
versus
heparin followed by an adjusted-dose vitamin K antagonist
|
patients with deep-vein thrombosis
|
follow-up 3 mo (6 mo)
n=1452/1452
Parallel groups
open
|
Romera, 2009
|
tinzaparin SC 175 IU anti-Xa per kg once daily for 6 months
versus
acenocoumarol for target INR 2-3 for 6 months after initial LMWH (until INR 2-3)
|
patients with symptomatic proximal DVT of the lowerlimbs confirmed by compression duplex ultrasound scan
|
follow-up 12 months
n=119/122
Parallel groups
open
Spain
|
Einstein-DVT Evaluation, 2010
NCT00440193
|
rivaroxaban 15 mg twice daily for 3 weeks, then 20 mg daily
versus
enoxaparin 1 mg/kg twice daily >=5 days, then warfarin with target INR between 2-3
|
Patients With Confirmed Acute Symptomatic Deep-Vein Thrombosis without Pulmonary Embolism
|
follow-up
n=-9/-9
Parallel groups
open (assessor-blind)
|
RE-COVER, 2009
NCT00291330
|
dabigatran 150 mg twice daily in a fixed-dose
versus
warfarin dose-adjusted to an INR between 2.0 and 3.0
|
patients with acute venous thromboembolism , treated with low molecular weight or unfractionated heparin for 5 to 11 days
|
follow-up 6 months
n=1274/1265
Parallel groups
double blind
|
VanGogh PE, 2007
NCT00062803
|
subcutaneous idraparinux (2.5 mg once weekly)
versus
heparin followed by an adjusted-dose vitamin K antagonist
|
patients with pulmonary embolism
|
follow-up 3 mo (6 mo)
n=1095/1120
Parallel groups
open
|
MATISSE PE, 2003
|
fondaparinux subcutaneously once daily
versus
continuous intravenous infusion of unfractionated
heparin
|
patients with acute symptomatic pulmonary embolism
|
follow-up 3 mo
n=1103/1110
Parallel groups
open
|
Einstein-PE Evaluation,
NCT00439777
|
versus
|
|
follow-up
n=-9/-9
|
CV185-056,
NCT00643201
|
apixaban 10 mg twice daily for 7 days then 5 mg, twice daily, 6 months
versus
enoxaparin 1mg/kg twice daily until INR>=2 then warfarin for an INR between 2-4, once daikly, 6 months
|
patients with deep vein thrombosis or pulmonary embolism
|
follow-up 6 mo
n=4816/0
Parallel groups
double blind
|
CV185-057,
NCT00633893
|
Extended Treatment with apixaban 5 or 2.5 mg twice daily 12 months
versus
placebo
|
patients who have completed their intended treatment for deep vein thrombosis or pulmonary embolism
|
follow-up 12 mo
n=2430/0
Parallel groups
double blind
|
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