??Paper of the day

?? Meta-analysis: Efficacy and safety of DOACs in patients with ESRD on Hemodialysis

??Published in: European Journal of Internal Medicine

https://www.ejinme.com/article/S0953-6205(23)00304-7/fulltext

??Summary: This systematic review and meta-analysis of 6 studies (3 RCTs and 3 observational studies) combining 21,692 patients, including 3225 patients on DOACs. The outcomes measured included ischemic stroke, the composite of ischemic stroke or systemic embolism, major bleeding, gastrointestinal bleeding, minor bleeding events and all-cause mortality.

?? takeaways:

1??Patients treated with DOACs had similar risk for ischemic stroke, composite of ischemic stroke/systemic embolism, minor and major bleeding, and all-cause mortality compared to those treated with VKAs.

2?? Risk of gastrointestinal bleeding was lower in DOACs- vs Vitamin k anatgonists (VKA)-treated patients in three eligible observational studies. However, the treatment effect was not found in RCTs.

??Limitations:

1. Long-term effect was not measured in these studies
2. Small number of patients may have cause statistical inconclusive results.