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Article dans une revue

Postthrombotic syndrome and quality of life after deep vein thrombosis in patients treated with edoxaban versus warfarin

Ingrid M. Bistervels Roisin Bavalia Jan Beyer-Westendorf 1 Arina J. Ten Cate-Hoek Sebastian M. Schellong Michael J. Kovacs 2 Nicolas Falvo 3 Karina Meijer 4 Dominique Stephan 5, 6 Wim G. Boersma Marije Ten Wolde Francis Couturaud 7 Peter Verhamme 8 Dominique Brisot 9 Susan R. Kahn Waleed Ghanima Karine Montaclair Amanda Hugman Patrick Carroll 10 Gilles Pernod 11, 12 Olivier Sanchez Emile Ferrari 13 Pierre-Marie Roy 14 Marie-Antoinette Sevestre-Pietri 15, 7 Simone Birocchi Hilde S. Wik Barbara A. Hutten Michiel Coppens Christiane Naue Michael A. Grosso Minggao Shi 16 Yong Lin Isabelle Quere 17 Saskia Middeldorp 18 
Abstract : Background Postthrombotic syndrome (PTS) is a long-term complication after deep vein thrombosis (DVT) and can affect quality of life (QoL). Pathogenesis is not fully understood but inadequate anticoagulant therapy with vitamin K antagonists is a known risk factor for the development of PTS. Objectives To compare the prevalence of PTS after acute DVT and the long-term QoL following DVT between patients treated with edoxaban or warfarin. Methods We performed a long-term follow-up study in a subset of patients with DVT who participated in the Hokusai-VTE trial between 2010 and 2012 (NCT00986154). Primary outcome was the prevalence of PTS, defined by the Villalta score. The secondary outcome was QoL, assessed by validated disease-specific (VEINES-QOL) and generic health-related (SF-36) questionnaires. Results Between 2017 and 2020, 316 patients were enrolled in 26 centers in eight countries, of which 168 (53%) patients had been assigned to edoxaban and 148 (47%) to warfarin during the Hokusai-VTE trial. Clinical, demographic, and thrombus-specific characteristics were comparable for both groups. Mean (SD) time since randomization in the Hokusai-VTE trial was 7.0 (1.0) years. PTS was diagnosed in 85 (51%) patients treated with edoxaban and 62 (42%) patients treated with warfarin (adjusted odds ratio 1.6, 95% CI 1.0-2.6). Mean differences in QoL scores between treatment groups were not clinically relevant. Conclusion Contrary to our hypothesis, the prevalence of PTS tended to be higher in patients treated with edoxaban compared with warfarin. No differences in QoL were observed. Further research is warranted to unravel the role of anticoagulant therapy on development of PTS.
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Soumis le : jeudi 25 août 2022 - 09:53:55
Dernière modification le : vendredi 9 septembre 2022 - 10:20:08




Ingrid M. Bistervels, Roisin Bavalia, Jan Beyer-Westendorf, Arina J. Ten Cate-Hoek, Sebastian M. Schellong, et al.. Postthrombotic syndrome and quality of life after deep vein thrombosis in patients treated with edoxaban versus warfarin. Research and Practice in Thrombosis and Haemostasis, Wiley, 2022, 6 (5), ⟨10.1002/rth2.12748⟩. ⟨hal-03760268⟩



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