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Meta-Analysis
. 2022 Jan;145(1):10-23.
doi: 10.1111/ane.13506. Epub 2021 Jul 21.

Safety and efficacy of Direct Oral Anticoagulants in cerebral venous thrombosis: A meta-analysis

Gaurav Nepal  1 , Sanjeev Kharel  1 , Riwaj Bhagat  2 , Yow Ka Shing  3 , Megan Ariel Coghlan  2 , Prasanta Poudyal  4 , Rajeev Ojha  5 , Gentle Sunder Shrestha  6
Affiliations
Meta-Analysis

Safety and efficacy of Direct Oral Anticoagulants in cerebral venous thrombosis: A meta-analysis

Gaurav Nepal et al. Acta Neurol Scand. 2022 Jan.

Abstract

Cerebral venous thrombosis (CVT) is caused by partial or complete occlusion of the major cerebral venous sinuses or the smaller feeding cortical veins which predispose to the risk of venous infarction and hemorrhage. Current guidelines recommend treating CVT with either low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH) followed by an oral vitamin K antagonist (VKA) for 3-12 months. Direct oral anticoagulants (DOACs) have already established benefit over warfarin as a long-term treatment of symptomatic venous thromboembolic disorder like deep vein thrombosis (DVT), and pulmonary embolism (PE) given its equal efficacy and better safety profile. The benefit of DOACs over warfarin as a long-term anticoagulation for CVT has likewise been extensively studied, yet it has not been approved as first-line therapy in the current practice. We therefore performed a systematic review and meta-analysis of relevant studies to generate robust evidence regarding the safety and efficacy of DOACs in CVT. This meta-analysis demonstrates that the use of DOACs in CVT has similar efficacy and safety compared to VKAs with better recanalization rate.

Keywords: CVST; CVT; DOAC; NOAC; apixaban; cerebral venous thrombosis; dabigatran; edoxaban; rivaroxaban.

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References

REFERENCES

    1. Ulivi L, Squitieri M, Cohen H, Cowley P, Werring DJ. Cerebral venous thrombosis: a practical guide. Pract Neurol. 2020;20(5):356-367.
    1. Bushnell C, Saposnik G. Evaluation and management of cerebral venous thrombosis. Contin Lifelong Learn Neurol. 2014;20(2):335-351.
    1. Silvis SM, De Sousa DA, Ferro JM, Coutinho JM. Cerebral venous thrombosis. Nat Rev Neurol. 2017;13(9):555-565.
    1. Ferro JM, Bousser M-G, Canhão P, et al. European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis - endorsed by the European Academy of Neurology. Eur J Neurol. 2017;24(10):1203-1213.
    1. Saposnik G, Barinagarrementeria F, Brown RD, et al. Diagnosis and management of cerebral venous thrombosis. Stroke. 2011;42(4):1158-1192. https://doi.org/10.1161/STR.0b013e31820a8364

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