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. 2020 Dec 10:11:597623.
doi: 10.3389/fneur.2020.597623. eCollection 2020.

Comparison of Novel Oral Anticoagulants and Vitamin K Antagonists in Patients With Cerebral Venous Sinus Thrombosis on Efficacy and Safety: A Systematic Review

Hongjie Li  1 , Meiling Yao  1 , Songjie Liao  1 , Jingyan Chen  1 , Jian Yu  1
Affiliations

Comparison of Novel Oral Anticoagulants and Vitamin K Antagonists in Patients With Cerebral Venous Sinus Thrombosis on Efficacy and Safety: A Systematic Review

Hongjie Li et al. Front Neurol. .

Abstract

Vitamin K antagonists (VKAs) are guideline-suggested subacute anticoagulants for cerebral venous sinus thrombosis (CVST), although there is potential hemorrhage risk in clinical use. In the last decade, novel oral anticoagulants (NOACs) have been applied as an alternative to VKAs in some kinds of thromboembolic diseases. Whether NOACs could replace VKAs in CVST treatment remains unclear. We conducted a comparison between the two types of medicines on efficacy and safety for the treatment of CVST based on the present clinical evidence from a literature search. Six studies [four retrospective studies, one prospective study, and 1 randomized clinical trial (RCT)] including 398 patients were included. Data suggested no significant difference between NOACs and VKAs in terms of recurrence of venous thrombotic events (VTEs) or death [risk ratio (RR) = 0.34, 95% confidence interval (CI) 0.06-1.98], partial recanalization (RR = 0.97, 95% CI 0.93-1.14), and overall hemorrhage events (RR = 0.86, 95% CI 0.47-1.58). In conclusion, the application of NOACs for CVST is similar to that of VKAs in terms of efficacy and safety.

Keywords: anticoagulant; cerebral venous sinus thrombosis; efficacy; hemorrhage; novel oral anticoagulants.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study selection.
Figure 2
Figure 2
Recurrence or death between novel oral anticoagulants (NOACs) and vitamin K antagonists (VKAs).
Figure 3
Figure 3
Full recanalization between NOACs and VKAs.
Figure 4
Figure 4
Partial recanalization between NOACs and VKAs.
Figure 5
Figure 5
Major bleeding events between NOACs and VKAs.
Figure 6
Figure 6
Overall bleeding events between NOACs and VKAs.
Figure 7
Figure 7
Excellent clinical outcome between NOACs and VKAs.
Figure 8
Figure 8
Bleeding events between dabigatran and VKAs.
Figure 9
Figure 9
Recanalization between dabigatran and VKAs.
Figure 10
Figure 10
Excellent clinical outcome between dabigatran and VKAs.
Figure 11
Figure 11
Recanalization between NOACs and phenprocoumon.
Figure 12
Figure 12
Bleeding events between NOACs and warfarin.
Figure 13
Figure 13
Recanalization between NOACs and warfarin.
Figure 14
Figure 14
Excellent clinical outcome between NOACs and warfarin.
See this image and copyright information in PMC

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