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Systematic Reviews

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Open Access 01-12-2019 | Dabigatran | Protocol

Direct oral anticoagulants in treatment of cerebral venous thrombosis: a systematic review protocol

Authors: Gauruv Bose, Justin Graveline, Vignan Yogendrakumar, Dean Fergusson, Dar Dowlatshahi

Published in: Systematic Reviews | Issue 1/2019

Abstract

Background and purpose

Cerebral venous thrombosis causes disability from venous infarct and hemorrhage and potential mortality. Anticoagulation improves survival and disability outcomes, yet direct oral anticoagulants are currently not indicated in cerebral venous thrombosis due to lack of evidence, despite being on the market for nearly a decade. This systematic review will collate evidence of reported safety and efficacy of direct oral anticoagulant therapy in cerebral venous thrombosis.

Methods

A search strategy was developed with a research librarian and registered on a protocol database (PROSPERO CRD42017078398). All published studies from MEDLINE and EMBASE up to February 2019 containing patients diagnosed with cerebral venous thrombosis who were treated with a direct oral anticoagulant (dabigatran, rivaroxaban, apixaban, or edoxaban) will be included. A risk of bias analysis will be performed to evaluate quality of studies overall.

Discussion

Current guidelines in the treatment of cerebral vein thrombosis dating back to 2011 from the American Heart Association/American Stroke Association endorse the utility of anticoagulation for the treatment of cerebral vein thrombosis; however, they did not support the use of direct oral anticoagulants. Updated guidelines from the European Stroke Organization, endorsed by the European Academy of Neurology in 2017, also refute utilization of direct oral anticoagulants due to a lack of evidence. There have been nearly 10 years of experience with direct oral anticoagulants in the treatment of venous thrombosis and prevention of stroke in patients with atrial fibrillation, with purported efficacy and safety in comparison with heparins and vitamin K antagonists. Our goal is to undertake a systematic review to assess the effectiveness and safety of direct oral anticoagulants in patients with cerebral vein thrombosis to help guide clinical decision-making for patients unable to take heparins or vitamin K antagonists and to direct future studies to contribute further to an area of certain evidence-based needs.

Systematic review registration

PROSPERO CRD42017078398

Available only for authorised users

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Title: Direct oral anticoagulants in treatment of cerebral venous thrombosis: a systematic review protocol
Authors: Gauruv Bose
Justin Graveline
Vignan Yogendrakumar
Dean Fergusson
Dar Dowlatshahi
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Dabigatran
Stroke
Venous Thrombosis
Direct Oral Anticoagulant
Thrombosis
Direct Oral Anticoagulant
Heparin
Venous Thrombosis
Rivaroxaban
Phlebography
Published in: Systematic Reviews / Issue 1/2019
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-019-1022-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Direct oral anticoagulants in treatment of cerebral venous thrombosis: a systematic review protocol

Abstract

Background and purpose

Methods

Discussion

Systematic review registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background and purpose

Methods

Discussion

Systematic review registration

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