Versiti Medical Director of Hematology Lisa Baumann Kreuziger, MD, MS, established the Venous thromboEmbolism Network U.S. (VENUS) to develop and conduct investigator-initiated clinical trials and research about thrombosis at research sites across the United States.
Recently, a VENUS research study was published in the Journal of Thrombosis and Thrombolysis that compared direct oral anticoagulants (DOACs) with warfarin in patients with obesity. DOACs are anticoagulant medications that are alternatives to traditional anticoagulants like warfarin and heparin. They are highly effective, do not require special testing or diets, and are considered to have fewer drug interactions than warfarin.1
However, the effectiveness and safety of DOACs in obese patients was less certain than warfarin. The VENUS study aimed to assess how effective and safe DOACs were compared to warfarin for the treatment of venous thromboembolism (VTE) in obese patients. The multi-center study compared adults with BMI ≥ 35 kg/m2 or weight ≥ 120 kg who were prescribed either a DOAC or warfarin for treatment of VTE.
Of the nearly 6,000 patients, 67% were prescribed warfarin and 33% were prescribed a DOAC. Researchers found that patients treated with a DOAC had a VTE recurrence rate of 3.6% and 0.5% major bleeding rate, compared with 3.8% VTE recurrence rate and 2.4% major bleeding rate for patients treated with warfarin.
Ultimately, researchers found that patients with obesity and VTE treated with DOACs experienced lower major bleeding compared to patients treated with warfarin. Similar numbers of patients had new VTE events, but the rate was higher than patients without obesity in other studies.