Evidence on use of therapeutic anticoagulation for treatment of VTE in elderly patients3
| TRIAL . | Drug and dose . | Number of patients . | Patients ≥75 . | Patients with CrCl ≤50 mL/min . | Pertinent results for elderly population . |
|---|---|---|---|---|---|
| EINSTEIN-DVT/PE4,5 | Rivaroxaban 15 mg twice daily for 3 weeks followed by 20 mg daily | 8281 Mean age = 57 years | 1283 (18%) | 664 (8%) | No differences in primary and safety outcome in different age, weight, and CrCl groups Excluded patients with “high risk of bleeding” (not defined) |
| RE-COVER6 | Dabigatran 150 mg twice daily | 2564 Mean age = 55 years | 290 (11.3%) | 133 (5.2%) | No differences in primary and safety outcome in different age, weight, and CrCl groups Excluded patients with “high risk of bleeding” (not defined) 100 mg or less of daily aspirin was acceptable |
| AMPLIFY7 | Apixaban 10 mg twice daily for 1 week, followed by 5 mg twice daily | 5395 Mean age = 57 years | 768 (14%) | 327 (6.2%) | No differences in primary outcome in different age, CrCl, and weight groups. Safety outcome favored apixaban for age subgroups 65-75 and >75 Safety outcome favored apixaban on weight >60 kg Excluded patients with “high risk of bleeding” (not defined), Hb <9 g/dL, platelets <100 000/m3, or patients on dual antiplatelet therapy Aspirin at a dose of 165 mg or less was accepted |
| HOKUSAI-VTE8 | Heparin lead-in followed by edoxaban 60 mg, or 30 mg in patients with CrCl 30-50 mL/min or weight <60 kg | n = 8292 Mean age = 55.8 years | 1004 (12%) | 541 (6.6%) | No differences in primary outcome and safety outcomes in different age and weight groups Excluded patients with “high risk of bleeding” (not defined) and CrCl <30 mg/dL 100 mg or less of daily aspirin was acceptable |
| TRIAL . | Drug and dose . | Number of patients . | Patients ≥75 . | Patients with CrCl ≤50 mL/min . | Pertinent results for elderly population . |
|---|---|---|---|---|---|
| EINSTEIN-DVT/PE4,5 | Rivaroxaban 15 mg twice daily for 3 weeks followed by 20 mg daily | 8281 Mean age = 57 years | 1283 (18%) | 664 (8%) | No differences in primary and safety outcome in different age, weight, and CrCl groups Excluded patients with “high risk of bleeding” (not defined) |
| RE-COVER6 | Dabigatran 150 mg twice daily | 2564 Mean age = 55 years | 290 (11.3%) | 133 (5.2%) | No differences in primary and safety outcome in different age, weight, and CrCl groups Excluded patients with “high risk of bleeding” (not defined) 100 mg or less of daily aspirin was acceptable |
| AMPLIFY7 | Apixaban 10 mg twice daily for 1 week, followed by 5 mg twice daily | 5395 Mean age = 57 years | 768 (14%) | 327 (6.2%) | No differences in primary outcome in different age, CrCl, and weight groups. Safety outcome favored apixaban for age subgroups 65-75 and >75 Safety outcome favored apixaban on weight >60 kg Excluded patients with “high risk of bleeding” (not defined), Hb <9 g/dL, platelets <100 000/m3, or patients on dual antiplatelet therapy Aspirin at a dose of 165 mg or less was accepted |
| HOKUSAI-VTE8 | Heparin lead-in followed by edoxaban 60 mg, or 30 mg in patients with CrCl 30-50 mL/min or weight <60 kg | n = 8292 Mean age = 55.8 years | 1004 (12%) | 541 (6.6%) | No differences in primary outcome and safety outcomes in different age and weight groups Excluded patients with “high risk of bleeding” (not defined) and CrCl <30 mg/dL 100 mg or less of daily aspirin was acceptable |