Anticoagulant drugs delay rather than reduce the risk
of recurrence of DVT
Using anticoagulants for longer than three months
to treat idiopathic deep vein thrombosis (DVT) delays recurrence rather
than reduces the risk of recurrence, Italian researchers say.
Dr Giancarlo Agnelli from the department of internal
medicine, University of Perugia, and colleagues randomised 267 patients,
who had completed three months of anticoagulant treatment following an
idiopathic DVT, to discontinue treatment or to continue for a further
nine months.
All patients were followed up for two years, at
the end of which 15.7 per cent of patients who continued treatment had
a recurrence of DVT compared with 15.8 per cent of those who discontinued
treatment. The average time to recurrence was 16.0 months from randomisation
in patients who continued treatment and 11.2 months in those who did not.
“These findings suggest that prolonging anticoagulant
therapy beyond three months simply delays recurrence until anticoagulant
therapy is stopped, rather than reducing the risk of recurrence,” the
researchers say.
Dr Agnelli and colleagues add that continuing anticoagulant
treatment indefinitely could extend the benefit but would be inconvenient
and would carry the risk of bleeding.
They suggest that patients with presumed idiopathic
DVT could be categorised to identify those at high risk of recurrence
after discontinuation of treatment (New England Journal of Medicine
2001;345:165).
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