AUTHOR=Lorenzo Alicia , Beroiz Patricia , Ortiz Salvador , del Toro Jorge , Mazzolai Lucia , Bura-Riviere Alessandra , Visonà Adriana , Verhamme Peter , Di Micco Pierpaolo , Camporese Giuseppe , Sancho Bueso Teresa , Monreal Manuel ,  the RIETE Investigators 

TITLE=Predictors of use of direct oral anticoagulants in patients with venous thromboembolism: Findings from the Registro Informatizado Enfermedad Tromboembólica registry

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.991376

DOI=10.3389/fmed.2022.991376

ISSN=2296-858X

ABSTRACT=Abstract
Background: Current guidelines recommend the use of direct oral
anticoagulants (DOACs) for patients with venous thromboembolism (VTE).
However, little is known about the use of DOACs in daily practice.
Methods: We used the RIETE registry to identify predictors of use of DOACs
for initial and/or long-term therapy of VTE based on patient-related factors,
institution-related factors or over time.
Results: Among 41,678 patients from March 2013 to September 2021, 12,286
(29%) used DOACs: for initial therapy 6,456; for long-term therapy12,046.On
multivariable analysis, independent predictors were: age <65 years (odds ratio
[OR]: 1.30; 95%CI: 1.23-1.38), body weight <50 kg (OR: 0.54; 95%CI: 0.45-
0.65) or >120 kg (OR: 0.64; 95%CI: 0.53-0.77), initial VTE presentation as
pulmonary embolism (OR: 1.18; 95%CI: 1.13-1.25), recent bleeding (OR: 0.53;
95%CI: 0.45-0.63), renal insufficiency (OR: 0.44; 95%CI: 0.38-0.51), liver
cirrhosis (OR: 0.32; 95%CI: 0.20-0.52), thrombocytopenia (OR: 0.40; 95%CI:
0.34-0.49), atrial fibrillation (OR: 1.58; 95%CI: 1.42-1.75) and prior VTE (OR:
1.14; 95%CI: 1.06-1.22). The DOACs were more likely used in other European
countries (OR: 8.97; 95%CI: 8.49-9.49), America (OR: 6.35; 95%CI: 5.67-7.11)
or in other countries of the world (OR: 2.99; 95%CI: 2.70-3.31) than in Spain,
and progressively increased from 2013-2015 to 2016-2018 (OR: 2.78; 95%CI:
2.62-2.95) and 2019-2021 (OR: 6.36; 95%CI: 5.95-6.80).
Conclusions: In this large multinational VTE registry, variations were observed
in the use of DOACs according to patient or country factors, and over time. The
safety, costs, and influence of the DOACs on VTE-related outcomes in daily
practice warrant further investigation.