Dr. Garber is an attending physician at MetroHealth Medical Center and assistant professor at Case Western Reserve University School of Medicine, both in Cleveland. Dr. Glauser is on the faculty of the Emergency Medicine Residency Program at MetroHealth Medical Center and professor of emergency medicine at Case Western Reserve University.
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ACEP Now: Vol 35 – No 08 – August 2016References
- Wells PS, Forgie MA, Rodger MA. Treatment of venous thromboembolism. JAMA. 2014;311(7):717-728.
- Yeh CH, Gross PL, Weitz JI. Evolving use of new oral anticoagulants for treatment of venous thromboembolism. Blood. 2014; 124(7):1020-1028.
- Zakai NA, McClure LA, Lutsey P, et al. Adoption of outpatient treatment of deep vein thrombosis in the U.S.: the reasons for geographic and racial differences in stroke study (REGARDS) [abstract]. Blood. 2014;686.
- Lozano F, Trujillo-Santos J, Barron M, et al. Home versus in-hospital treatment of patients with acute deep venous thrombosis of the lower limbs. J Vasc Surg. 2014;59:1362-1327.
- Fahad M, Al-Hameed MD, Hasan M, et al. The Saudi clinical practice guideline for the treatment of venous thromboembolism: outpatient versus inpatient management. Saudi Med J. 2015;36(8):1004-1010.
- Zakai NA, McClure LA, Lutsey PL, et al. Adoption of outpatient treatment of deep vein thrombosis in the US: The reasons for geographic and racial differences in stroke study (REGARDS). 56th American Society of hematology (ASH) Meeting and Exposition, Dec 2014. Abstr
- Kakkos SK, Kirkilesis GI, Tsolakis IA. Efficacy and safety of the new oral anticoagulants dabigatran, rivaroxaban, apixaban, and edoxaban in the treatment and secondary prevention of venous thromboembolism: a systematic review and meta-analysis of phase III trials. Eur J Vasc Endovasc Surg. 2014;48(5):565-575.
- Edoxaban (savaysa) – the fourth new oral anticoagulant. The Medical Letter. 2015;57(1465):43-44.
- Hu TY, Vaidya VR, Asirvatham SJ. Reversing anticoagulant effects of novel oral anticoagulants: role of ciraparantag, andexanet alfa, and idarucizumab. Vasc Health Risk Manag. 2016;12:35-44.
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4 Responses to “Options, Approaches to Outpatient Treatment of Deep Vein Thrombosis for Emergency Physicians”
August 24, 2016
Sunjeev Konduru, MS, PharmD, BCPSThe dosing of apixaban in this article does not match the FDA prescribing information, which states give 10mg twice a day for 7 days, followed by 5mg twice a day. This dose of Eliquis was studied in the AMPLIFY trial for 6 months versus lovenox and warfarin in patients with symptomatic PE or proximal DVT.
Edoxaban also required initial parenteral anticoagulation for 5 to 10 days, similar to dabigatran.
Thank you.
August 28, 2016
jakeYou correctly point out dabigatran as a direct thrombin inhibitor in the text of the article, however, in the table it is incorrectly listed as a Xa inhibitor.
August 30, 2016
Dawn Antoline-WangThank you, the table has been updated to reflect this correction.
August 29, 2016
Soumya Ganapathy MDGreat article. When treating DVTs and PEs as an outpatient, patient education is paramount. Patient and their families can often feel overwhelmed. ACEP has a program called knowbloodclots.com, it is a great resource for patient education on DVTs and PEs. They have nice videos like what to expect with DVT and PE treatment as well as warning videos on the risk of bleeding. They also have a free texting program that sends reminders and educational links to patients.