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Colegio de Medicina Interna de México.

2023, Number 4

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Med Int Mex 2023; 39 (4)

Use of factor Xa/direct oral anticoagulants inhibitors compared to warfarin in obese patients

Murcia AX, Quemba MMP

Language: Spanish
References: 21
Page: 629-641
PDF size: 231.59 Kb.


ABSTRACT

Objective: To evaluate the differences in the clinical results of the use of factor Xa inhibitors/direct oral anticoagulants compared with warfarin in patients with obesity.
Methodology: Systematic review of observational and experimental studies published from 2010 to 2020 in the databases PubMed, Scopus, Web of Science, Lilacs, Scielo, Cochrane Central Register of Trials, under validated search terms: Factor Xa Inhibitors; Anticoagulants; Obesity; Atrial Fibrillation and Venous Thromboembolism.
Results: Seven observational studies (n: 9572) and 2 clinical trials (n: 6611) were included, these met most of the methodological quality criteria of the Strobe and Consort checklists, respectively; experimental studies had low to unclear risk of bias. The meta-analysis was performed in the RevMan 5.4 software, calculating risk estimators with 95% confidence intervals. For the major bleeding outcome, a RR of 0.65 was obtained (95% CI: 0.54-0.79; two trials; n: 6611); the analyzes were not statistically significant for the other outcomes.
Conclusions: There are favorable results in the use of factor Xa/direct oral anticoagulants inhibitors compared with warfarin for the clinical outcome of major bleeding. Further experimental research is needed on the clinical outcomes, pharmacokinetics, and pharmacodynamics in obese patients of these drugs.


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