Comparative Effectiveness of Warfarin and New Anticoagulants (2013)

Letters16 April 2013Comparative Effectiveness of Warfarin and New AnticoagulantsSoheir S. Adam, MD, Thomas L. Ortel, MD, PHD, and John W. Williams Jr., MDSoheir S. Adam, MDFrom Duke University Medical Center and Durham Veterans Affairs Medical Center, Durham, North Carolina.Search for more papers by this author, Thomas L. Ortel, MD, PHDFrom Duke University Medical Center and Durham Veterans Affairs Medical Center, Durham, North Carolina.Search for more papers by this author, and John W. Williams Jr., MDFrom Duke University Medical Center and Durham Veterans Affairs Medical Center, Durham, North Carolina.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-8-201304160-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the comments on our review, particularly about whether to pool across drugs, the key outcomes, and whether adherence can be monitored with laboratory testing. A critical issue for all meta-analyses is whether and how to pool results. We chose to pool results by condition for the primary outcomes, because outcomes are condition-specific, and across conditions for adverse effects common to these drug classes. Dabigatran and factor Xa inhibitors are all NOACs that have a similar mechanism of action because they each target a single enzyme in the coagulation cascade. Although we considered the study designs and ...References1. You JJ, Singer DE, Howard PA, Lane DA, Eckman MH, Fang MC, et al; American College of Chest Physicians. Antithrombotic therapy for atrial fibrillation: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:531S-75S. [PMID: 22315271] CrossrefMedlineGoogle Scholar2. Freemantle N, Calvert M, Wood J, Eastaugh J, Griffin C. Composite outcomes in randomized trials: greater precision but with greater uncertainty? JAMA. 2003;289:2554-9. [PMID: 12759327] CrossrefMedlineGoogle Scholar3. Ferreira-González I, Busse JW, Heels-Ansdell D, Montori VM, Akl EA, Bryant DM, et al. Problems with use of composite end points in cardiovascular trials: systematic review of randomised controlled trials. BMJ. 2007;334:786. [PMID: 17403713] CrossrefMedlineGoogle Scholar4. Funk DM. Coagulation assays and anticoagulant monitoring. Hematology Am Soc Hematol Educ Program. 2012;2012:460-5. [PMID: 23233620] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Soheir S. Adam, MD; Thomas L. Ortel, MD, PHD; John W. WilliamsJr., MDAffiliations: From Duke University Medical Center and Durham Veterans Affairs Medical Center, Durham, North Carolina.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-1317. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparative Effectiveness of Warfarin and New Oral Anticoagulants for the Management of Atrial Fibrillation and Venous Thromboembolism Soheir S. Adam , Jennifer R. McDuffie , Thomas L. Ortel , and John W. Williams Jr. Comparative Effectiveness of Warfarin and New Anticoagulants Robert L. Trowbridge and Kathryn E. Smith Comparative Effectiveness of Warfarin and New Anticoagulants James A. Reiffel Metrics 16 April 2013Volume 158, Issue 8 Page: 637-638 Keywords Drugs Myocardial infarction Partial thromboplastin time Patients Prothrombin time Research design Research laboratories Risk management Thorax Thrombin ePublished: 16 April 2013 Issue Published: 16 April 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...