Are DOACs Actually Safer in Advanced Cirrhosis – RPTH Journal
RPTH Journal shared a post on LinkedIn about a recent article by Daniel Tham et al, adding:
“Are DOACs actually safer in advanced cirrhosis?
For years, anticoagulation in Child-Pugh B/C cirrhosis has lived in the “too risky / not enough data” zone. This new meta-analysis pushes that conversation forward in a big way.
Across 16 studies and >17,000 patients, DOACs were compared with warfarin/LMWH in cirrhosis.
Here’s what stood out
Major bleeding was LOWER with DOACs
- CP B/C subgroup: OR 0.53
- Overall cohort: OR 0.60
- No increase in VTE recurrence or stroke risk
- Minor bleeding also trended lower overall
Translation: DOACs may not just be convenient; they may actually be safer than traditional anticoagulation in cirrhosis.
But here’s the nuance:
Most data remain observational, and evidence in Child-Pugh C is still limited. We’re seeing strong signals, not the final word.
This is exactly the type of evidence clinicians have been waiting for to guide real-world decision-making in a notoriously difficult population.”
Title: Safety and efficacy of direct oral anticoagulants in patients with liver cirrhosis: a meta-analysis
Authors: Daniel Tham, Wenhui Yu, Lucy Zhao, Roger Kou, Jayhan Kherani, Pei Yi Li, Shreyas Sreeraman, Ali Eshaghpour, Allen Li, Mark A. Crowther
Read the Full Article on RPTH Journal.
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