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Evidence summaries

Anticoagulants Versus Nsaids or Placebo for Venous Thromboembolism

There is no trial evidence on the efficacy and safety of anticoagulants in venous thromboembolism as compared to no anticoagulation, but their use is widely accepted in clinical practice based on secondary evidence. Level of evidence: "D"

A Cochrane review [Abstract] 1 included two small studies comparing anticoagulant treatment to NSAIDs or placebo in patients with venous thromboembolism (VTE), with a total of 113 participants treated over three months. The two RCTs were too small to determine any difference in mortality, occurrence of pulmonary emboli, progression or return of DVT between patients treated with anticoagulation and those receiving no anticoagulation.

Authors' comment: Even if RCT evidence is sparse, the use of anticoagulants in the treatment of VTE is widely accepted in clinical practice based on secondary evidence, so a further RCT comparing anticoagulants to placebo could not ethically be carried out.

    References

    • Cundiff DK, Manyemba J, Pezzullo JC. Anticoagulants versus non-steroidal anti-inflammatories or placebo for treatment of venous thromboembolism. Cochrane Database Syst Rev 2006 Jan 25;(1):CD003746. [PubMed]

Primary/Secondary Keywords