Summary of meta-analyses comparing direct oral anticoagulants with vitamin K antagonists in the obese population with VTE
| Study . | Obesity definition . | n (studies) . | N (patients) . | Recurrent VTEOR, RR, or IRR (95% CI) . | Major bleedingOR, RR, or IRR (95% CI) . | Conclusion . |
|---|---|---|---|---|---|---|
| Elshafei et al6 (2020) | Weight >120 kg or BMI >40 kg/m2 | 5 | 6642 | OR 1.07 (0.93-1.23) | OR 0.80 (0.54-1.17) | Use of DOACs in patients with weight >120 kg or BMI >40 kg/m2 is effective and safe |
| Mai et al7 (2020) | BMI ≥30 kg/m2 | 11 | 14 890 | RR 1.03 (0.93-1.15) | RR 0.57 (0.34-0.94) | Comparable outcomes with DOACs vs VKA/LMWH in those with BMI ≥30 kg/m2 and ≥40 kg/m2 |
| BMI ≥40 kg/m2 | 4 | 6304 | RR 1.06 (0.94-1.19) | RR 0.71 (0.50-1.00) | ||
| Wang et al8 (2021) | Weight ≥120 kg or BMI ≥40 kg/m2 | 9 | 5148 | IRR 0.58 (0.44-0.77) | IRR 0.68 (0.41-1.11) | Compared to VKAs, DOACs were associated with lower rates of recurrent VTE and similar rates of major bleeding |
| Study . | Obesity definition . | n (studies) . | N (patients) . | Recurrent VTEOR, RR, or IRR (95% CI) . | Major bleedingOR, RR, or IRR (95% CI) . | Conclusion . |
|---|---|---|---|---|---|---|
| Elshafei et al6 (2020) | Weight >120 kg or BMI >40 kg/m2 | 5 | 6642 | OR 1.07 (0.93-1.23) | OR 0.80 (0.54-1.17) | Use of DOACs in patients with weight >120 kg or BMI >40 kg/m2 is effective and safe |
| Mai et al7 (2020) | BMI ≥30 kg/m2 | 11 | 14 890 | RR 1.03 (0.93-1.15) | RR 0.57 (0.34-0.94) | Comparable outcomes with DOACs vs VKA/LMWH in those with BMI ≥30 kg/m2 and ≥40 kg/m2 |
| BMI ≥40 kg/m2 | 4 | 6304 | RR 1.06 (0.94-1.19) | RR 0.71 (0.50-1.00) | ||
| Wang et al8 (2021) | Weight ≥120 kg or BMI ≥40 kg/m2 | 9 | 5148 | IRR 0.58 (0.44-0.77) | IRR 0.68 (0.41-1.11) | Compared to VKAs, DOACs were associated with lower rates of recurrent VTE and similar rates of major bleeding |
IRR, incidence rate ratio; OR, odds ratio.