PDF(Pubmed)
Abstract：
UNASSIGNED: Hospitalized patients with COVID-19 have shown a significant occurrence of thromboembolism and a heightened risk of death. It remains unclear whether factor Xa inhibitors are superior to enoxaparin in this context. Hence, there is a need for a direct comparison to assess the preventive effects and safety of factor Xa inhibitors versus enoxaparin in hospitalized COVID-19 patients.
UNASSIGNED: MEDLINE, Embase, and Cochrane Central databases were searched for randomized controlled trials (RCTs) or retrospective studies that compared the effectiveness or safety of factor Xa inhibitors and enoxaparin in preventing thromboembolism in hospitalized patients with COVID-19. Embolic incidence, incidence of bleeding, and all-cause mortality were among the outcomes of interest. Mantel-Haenszel weighted random-effects model was used to calculate relative risks (RRs) with 95 percent CIs.
UNASSIGNED: The analysis included six RCTs and two retrospective studies containing 4048 patients. Meta-analysis showed a statistically significant reduction among patients on factor Xa inhibitors compared with low-molecular-weight heparin (LMWH) in the embolic incidence [risk ratio (RR) 0.64 (95%, CI 0.42, 0.98); P=0.04, I2=12%]. Upon subgroup analysis by type of study design, no significant reductions were noted in patients on factor Xa inhibitors in RCTs (RR: 0.62; 95% CI: 0.33-1.17; P=0.14) or observational studies (RR: 0.53; 95% CI: 0.23-1.26; P=0.15) when compared with enoxaparin Factor Xa inhibitors were not significantly associated with incidence of bleeding [RR 0.76 (95% CI 0.36, 1.61); P=0.47, I2=0%] or all-cause mortality (RR: 0.81; 95% CI: 0.48-1.36; P=0.43). Consistent results were obtained upon subgroup analysis by the type of study design.
UNASSIGNED: Factor Xa inhibitors are more effective than enoxaparin in preventing thromboembolism among patients with COVID-19 who are not acutely ill and are hospitalized. Additional rigorous RCTs comparing factor Xa inhibitors with enoxaparin are warranted.
UNASSIGNED: MEDLINE, Embase, and Cochrane Central databases were searched for randomized controlled trials (RCTs) or retrospective studies that compared the effectiveness or safety of factor Xa inhibitors and enoxaparin in preventing thromboembolism in hospitalized patients with COVID-19. Embolic incidence, incidence of bleeding, and all-cause mortality were among the outcomes of interest. Mantel-Haenszel weighted random-effects model was used to calculate relative risks (RRs) with 95 percent CIs.
UNASSIGNED: The analysis included six RCTs and two retrospective studies containing 4048 patients. Meta-analysis showed a statistically significant reduction among patients on factor Xa inhibitors compared with low-molecular-weight heparin (LMWH) in the embolic incidence [risk ratio (RR) 0.64 (95%, CI 0.42, 0.98); P=0.04, I2=12%]. Upon subgroup analysis by type of study design, no significant reductions were noted in patients on factor Xa inhibitors in RCTs (RR: 0.62; 95% CI: 0.33-1.17; P=0.14) or observational studies (RR: 0.53; 95% CI: 0.23-1.26; P=0.15) when compared with enoxaparin Factor Xa inhibitors were not significantly associated with incidence of bleeding [RR 0.76 (95% CI 0.36, 1.61); P=0.47, I2=0%] or all-cause mortality (RR: 0.81; 95% CI: 0.48-1.36; P=0.43). Consistent results were obtained upon subgroup analysis by the type of study design.
UNASSIGNED: Factor Xa inhibitors are more effective than enoxaparin in preventing thromboembolism among patients with COVID-19 who are not acutely ill and are hospitalized. Additional rigorous RCTs comparing factor Xa inhibitors with enoxaparin are warranted.
摘要：
■住院的COVID-19患者显示出明显的血栓栓塞发生率和死亡风险增加。在这种情况下，尚不清楚Xa因子抑制剂是否优于依诺肝素。因此，有必要进行直接比较,以评估Xa因子抑制剂与依诺肝素在住院COVID-19患者中的预防效果和安全性.
■MEDLINE,Embase,我们在CochraneCentral数据库中搜索了随机对照试验(RCT)或回顾性研究,这些研究比较了Xa因子抑制剂和依诺肝素在COVID-19住院患者中预防血栓栓塞的有效性或安全性.栓塞发生率,出血发生率，全因死亡率是关注的结局之一.使用Mantel-Haenszel加权随机效应模型计算95%CI的相对风险(RR)。
■分析包括6项随机对照试验和2项包含4048例患者的回顾性研究。荟萃分析表明，与低分子量肝素（LMWH）相比，使用Xa因子抑制剂的患者的栓塞发生率[风险比（RR）0.64（95％，CI0.42，0.98）；P=0.04，I2=12%]。根据研究设计类型的亚组分析，在RCTs(RR:0.62;95%CI:0.33-1.17;P=0.14)或观察性研究(RR:0.53;95%CI:0.23-1.26;P=0.15)中,使用Xa因子抑制剂的患者与出血发生率无显著相关性[RR0.76(95%CI0.36,1.61);P=0.47,全部原因0.48通过研究设计类型的亚组分析获得了一致的结果。
■因子Xa抑制剂比依诺肝素更有效地预防COVID-19患者的血栓栓塞。有必要进行其他严格的RCT比较因子Xa抑制剂与依诺肝素。
■MEDLINE,Embase,我们在CochraneCentral数据库中搜索了随机对照试验(RCT)或回顾性研究,这些研究比较了Xa因子抑制剂和依诺肝素在COVID-19住院患者中预防血栓栓塞的有效性或安全性.栓塞发生率,出血发生率，全因死亡率是关注的结局之一.使用Mantel-Haenszel加权随机效应模型计算95%CI的相对风险(RR)。
■分析包括6项随机对照试验和2项包含4048例患者的回顾性研究。荟萃分析表明，与低分子量肝素（LMWH）相比，使用Xa因子抑制剂的患者的栓塞发生率[风险比（RR）0.64（95％，CI0.42，0.98）；P=0.04，I2=12%]。根据研究设计类型的亚组分析，在RCTs(RR:0.62;95%CI:0.33-1.17;P=0.14)或观察性研究(RR:0.53;95%CI:0.23-1.26;P=0.15)中,使用Xa因子抑制剂的患者与出血发生率无显著相关性[RR0.76(95%CI0.36,1.61);P=0.47,全部原因0.48通过研究设计类型的亚组分析获得了一致的结果。
■因子Xa抑制剂比依诺肝素更有效地预防COVID-19患者的血栓栓塞。有必要进行其他严格的RCT比较因子Xa抑制剂与依诺肝素。
