Direct Oral Anticoagulants Versus Warfarin for Venous Thromboembolism Prophylaxis in Nephrotic Syndrome Patients: a Retrospective Study

Overview

Journal Thromb J

Publisher Biomed Central

Date 2025 Jan 30

PMID 39885575

Authors

Ahmed El-Bardissy

Mohamed Nabil Elshafei

Hebatullah Abdelgawad

Rana Mekkawi

Asma Eltahir

AbdulMoqeeth Mohammed

Ashour Am

Hazem Elewa

Affiliations

Soon will be listed here.

Abstract

Background: Nephrotic syndrome (NS) is associated with an increased risk of venous thromboembolism (VTE). Anticoagulants are widely used in the prevention of VTE in NS patients. The use of direct oral anticoagulants (DOACs) has not been studied intensively in NS patients. The aim of this study is to determine the efficacy and safety of DOACs compared to warfarin for prophylactic anticoagulation in patients with nephrotic syndrome.

Methods: Retrospective analysis conducted in a tertiary hospital-based ambulatory anticoagulation clinic between 01/07/2016 and 29/11/2021. We aimed to evaluate the incidence of VTE, major bleeding, and non-major bleeding in both the DOACs and warfarin groups.

Results: Fifty-seven patients were recruited, 31 patients were prescribed warfarin (54.4%), and 26 were on DOAC (45.6%). Two patients in the DOAC group developed VTE, while no subjects in the warfarin group developed VTE, however, the difference was not statistically significance (p = 0.2). Nine out of 31 patients in the warfarin group developed non-major bleeding compared to three patients in the DOAC group (p = 0.02). One patient developed major bleeding in each group DOAC group 1 (15.4%), warfarin 1 (12.9%) (p = 1.00). There was no statistically significant difference in major bleeding between DOAC and warfarin groups (p = 1.00).

Conclusion: In patients with NS, preliminary evidence suggests that DOACs have comparable efficacy as compared to warfarin when used as prophylaxis. Additionally, DOACs result in lower incidences of non-major bleeding. However, further studies are indicated to confirm the superiority of DOACs over warfarin.

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