JAHA: Direct oral anticoagulants and venous thromboembolism in patients with hereditary haemophilia

In this prospective cohort study, researchers aim to assess the efficacy and safety of direct oral anticoagulants (DOACs) and heparin/vitamin K antagonists in the treatment of venous thrombosis (VTE) in patients with hereditary haemophilia.
VTE and hereditary haemophilia patients treated with DOAC (case) or heparin/vitamin K antagonists (control group) were matched by age, sex, race, and type of thrombosis.
the end of the study were VTE recurrence and bleeding complications, residual venous thrombosis and post-thrombosis syndrome, and VTE recurrence after the end of anticoagulants.
the study included 255 cases (age 52.4±17.3 years, 44.3 per cent for women and 33.1 per cent for severe thrombosis) and 322 controls (age 49.7±18.1 years, 50.3 per cent for women and 35.1 per cent for severe haemophilia.
cases, the cumulative rate of VTE recurrence during anticoagulant therapy was 1.09%, and the adjusted risk ratio (HR) was 0.67 (95% CI was 0.16-2.77).
10.2 per cent in the case group and 2.24 in HR (95 per cent CI was 1.10-4.58).
no major bleeding occurred in the case group (3 cases in the control group).
there was no significant difference between residual venous thrombosis and post-thrombosis syndrome.
deactivation of anticoagulants, DOACs significantly reduce the risk of recurrence of 2-year VTE (HR is 0.61 (95% CI is 0.47-0.82).
results, DOACs and heparin/vitamin K antagonists have similar efficacy in treating VTE in haemophilia patients.
despite hemorrhage events using heparin/vitamin K antagonists, DOAC overall increased bleeding rates.
the use of anticoagulants, the use of DOAC reduces the risk of recurrence of VTE for 2 years.
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