Efficacy And Safety Of Non-vitamin K Antagonist Oral Anticoagulants For Venous Thromboembolism:A Meta-analysis

Object : To evaluate the efficacy and safety of non-vitamin K antagonist oral anticoagulants in treating venous thromboembolism.Methods : Data of randomized controlled trials and multicenter controlled studies about non-vitamin K antagonist oral anticoagulants versus vitamin K antagonists for treating venous thromboembolism were searched from PubMed、Cochrane Library and EMbase until June 2017,and data were analyzed by RevMan 5.3 software.Results : A total of 29879 patients were included in 7 studies,Meta-analysis showed that:(1)Compared with traditional vitamin K antagonists,the new oral non-vitamin K antagonist anticoagulants could significantly reduce major bleeding events(OR=0.61,95%CI=0.50~0.75,P<0.00001)and fatal bleeding events(OR = 0.37,95% CI = 0.17-0.81,P = 0.01);(2)non-vitamin K antagonist oral anticoagulants could not reduce the incidence of recurrent venous thromboembolism or venous thromboembolism-related death(OR = 0.94,95% CI = 0.81-0.18,P = 0.38)or all-cause mortality(OR=0.97,95%CI=0.83~1.13,P=0.70)compared with vitamin K antagonists;(3)The results of adverse events can not be combined and analyzed,the safety of non-vitamin K antagonist oral anticoagulants needs to be further evaluated.Conclusion : The efficacy of non-vitamin K antagonist oral anticoagulants in treating venous thromboembolism is no less than that of traditional vitamin K antagonists,and the former could reduce bleeding events significantly though their safety needs to be further evaluated.