{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:55:39Z","timestamp":1781844939921,"version":"3.54.5"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Evidence on the use of direct oral anticoagulants (DOACs) in upper extremity deep vein thrombosis (UEDVT) remains limited. This study examines real-world outcomes of DOACs compared with standard anticoagulation therapy for UEDVT patients.<\/jats:p>\n                  <jats:p>Using the RIETE (Registro Informatizado de Enfermedad TromboEmb\u00f3lica) database, we conducted an observational analysis of UEDVT patients treated with DOACs or standard therapy (low molecular weight heparin [LMWH] or vitamin K antagonists for noncancer patients, and LMWH for cancer patients). Patients with events during the first 5 days of treatment were excluded. The primary outcome was a composite of venous thromboembolism (VTE) recurrence and major bleeding during the first 3 months of therapy. Multivariable and multilevel analyses were conducted to adjust for confounding.<\/jats:p>\n                  <jats:p>Between January 2011 and November 2023, 3,496 UEDVT patients met the inclusion criteria. Of these, 679 (19.4%) received DOACs, whereas 2,817 (80.6%) received standard therapy. The composite outcome occurred in seven patients (1.0%) on DOACs (5 [0.7%] VTE recurrence, 2 [0.3%] major bleeding) compared with 78 patients (2.8%) on standard therapy (51 [1.8%] VTE recurrence, 29 [1.0%] major bleeding; p\u2009&lt;\u20090.001). Multivariable analysis showed that DOAC use was associated with a lower risk of the composite outcome (adjusted subhazard ratio: 0.41; 95% confidence interval: 0.19\u20130.90). These findings remained consistent in multilevel models and sensitivity analyses stratified by cancer and catheter-related thrombosis.<\/jats:p>\n                  <jats:p>This real-world analysis suggests that DOACs may be associated with a lower risk of VTE recurrence and major bleeding compared with standard therapy in patients with UEDVT. These findings support DOACs as a viable treatment option.<\/jats:p>","DOI":"10.1055\/a-2615-4513","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T20:01:01Z","timestamp":1747684861000},"page":"287-296","source":"Crossref","is-referenced-by-count":1,"title":["Direct Oral Anticoagulants versus Standard Therapy in Upper Extremity Deep Vein Thrombosis: Real-World Evidence"],"prefix":"10.1055","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5680-9883","authenticated-orcid":false,"given":"Pedro","family":"Ruiz-Artacho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cl\u00ednica Universidad de Navarra, Madrid, Spain"},{"name":"Interdisciplinar Teragnosis and Radiosomics Research Group (INTRA-Madrid), Universidad de Navarra, Madrid, Spain"},{"name":"CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8850-8866","authenticated-orcid":false,"given":"Ram\u00f3n","family":"Lecumberri","sequence":"additional","affiliation":[{"name":"Department of Haematology, Cl\u00ednica Universidad de Navarra, Pamplona, Spain"},{"name":"CIBER Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Trujillo-Santos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital General Universitario Santa Luc\u00eda, Cartagena, Murcia, Spain"},{"name":"Universidad Cat\u00f3lica San Antonio de Murcia, Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahd","family":"Beddar Chaib","sequence":"additional","affiliation":[{"name":"Emergency Department, Complejo Asistencial de Soria, Soria, Spain"},{"name":"Faculty of Health Sciences, Universidad de Valladolid, Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Far\u00e8s","family":"Moustafa","sequence":"additional","affiliation":[{"name":"Emergency Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Lorenzo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2294-2229","authenticated-orcid":false,"given":"Covadonga","family":"G\u00f3mez-Cuervo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1897-7832","authenticated-orcid":false,"given":"Marijan","family":"Bosevski","sequence":"additional","affiliation":[{"name":"University Stt. Cyril and Methodius, Faculty of Medicine, University Clinic of Cardiology, Skopje, North Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Monreal","sequence":"additional","affiliation":[{"name":"CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain"},{"name":"Chair for the Study of Thromboembolic Disease, Faculty of Health Sciences, UCAM\u2014Universidad Cat\u00f3lica San Antonio de Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the RIETE Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1378\/chest.07-1432","article-title":"Clinical outcome of patients with upper-extremity deep vein thrombosis: results from the RIETE Registry","volume":"133","author":"F J 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