{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T23:01:01Z","timestamp":1785366061467,"version":"3.55.0"},"reference-count":12,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Direct oral anticoagulants (DOACs) are increasingly used for superficial vein thrombosis (SVT), yet evidence remains limited. This systematic review and meta-analysis synthesizes all available data on the efficacy and safety of DOACs in SVT.<\/jats:p>\n                  <jats:p>A systematic search identified randomized and observational studies enrolling adults with acute SVT treated with DOACs. Primary efficacy outcomes were venous thromboembolism (VTE: deep vein thrombosis or pulmonary embolism) and SVT recurrence\/extension. Safety outcomes included major and clinically relevant non-major bleeding (CRNMB).<\/jats:p>\n                  <jats:p>Six studies (n\u2009=\u20092,040; 602 DOAC-treated patients) met the inclusion criteria. Compared with fondaparinux, DOACs showed comparable short-term efficacy for VTE prevention (pooled risk ratio [RR] 0.93, 95% CI 0.44\u20131.99) and similar rates of SVT recurrence (RR 1.30, 95% CI 0.65\u20132.62). Versus placebo, rivaroxaban reduced recurrence by approximately 80% (RR 0.20, 95% CI 0.03\u20131.35). In the pooled safety analysis including four studies, DOACs were associated with a 65% relative risk reduction in major or CRNMB compared with fondaparinux or low-molecular-weight heparin (RR 0.35, 95% CI 0.15\u20130.83; I\n                  2\u2009=\u20090%). In the TROLL registry (n\u2009=\u2009229; 74% DOAC), no major bleeding occurred among DOAC users, while 5-year cumulative VTE and SVT recurrence rates were each 15.9%. Certainty of evidence was moderate for efficacy and high for safety.<\/jats:p>\n                  <jats:p>DOACs demonstrate efficacy comparable to fondaparinux and an excellent safety profile in SVT, supporting their use as a practical oral alternative. Long-term data indicate persistent thrombotic risk, suggesting potential benefit of extended low-dose prophylaxis in selected high-risk patients.<\/jats:p>","DOI":"10.1055\/a-2788-3034","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T23:48:52Z","timestamp":1768520932000},"page":"832-842","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and Safety of DOACs for the Treatment of Superficial Vein Thrombosis: A Systematic Review and Meta-Analysis"],"prefix":"10.1055","volume":"126","author":[{"given":"Andrea","family":"Boccatonda","sequence":"additional","affiliation":[{"name":"Diagnostic and Therapeutic Interventional Ultrasound Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Brighenti","sequence":"additional","affiliation":[{"name":"Diagnostic and Therapeutic Interventional Ultrasound Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Simion","sequence":"additional","affiliation":[{"name":"Department of Medicine, General Medicine and Thrombotic and Hemorrhagic Diseases Unit, University Hospital of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Simioni","sequence":"additional","affiliation":[{"name":"Department of Medicine, General Medicine and Thrombotic and Hemorrhagic Diseases Unit, University Hospital of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Campello","sequence":"additional","affiliation":[{"name":"Department of Medicine, General Medicine and Thrombotic and Hemorrhagic Diseases Unit, University Hospital of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"issue":"22","key":"ref1","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1001\/jama.2025.15222","article-title":"Superficial vein thrombosis: A review","volume":"334","author":"G Piazza","year":"2025","journal-title":"JAMA"},{"issue":"14","key":"ref2","doi-asserted-by":"crossref","first-page":"5024","DOI":"10.3390\/jcm14145024","article-title":"Superficial vein thrombosis in obese patients","volume":"14","author":"L Ordieres-Ortega","year":"2025","journal-title":"J Clin Med"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.mcna.2025.03.006","article-title":"Superficial vein thrombosis","volume":"109","author":"O Moreno-Rocha","year":"2025","journal-title":"Med Clin North Am"},{"issue":"02","key":"ref4","first-page":"CD004982","article-title":"Treatment for superficial thrombophlebitis of the leg","volume":"2","author":"M Di Nisio","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"issue":"13","key":"ref5","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1056\/NEJMoa0912072","article-title":"Fondaparinux for the treatment of superficial-vein thrombosis in the legs","volume":"363","author":"H Decousus","year":"2010","journal-title":"N Engl J Med"},{"key":"ref6","first-page":"162","article-title":"Unresolved questions on venous thromboembolic disease. Therapeutic management of superficial vein thrombosis (SVT). Consensus statement of the French Society for Vascular Medicine (SFMV)","volume":"49","author":"M A Sevestre","year":"2024","journal-title":"J Med Vasc"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"e105","DOI":"10.1016\/S2352-3026(17)30014-5","article-title":"Prevention of thromboembolic complications in patients with superficial-vein thrombosis given rivaroxaban or fondaparinux: the open-label, randomised, non-inferiority SURPRISE phase 3b trial","volume":"4","author":"J Beyer-Westendorf","year":"2017","journal-title":"Lancet Haematol"},{"issue":"08","key":"ref8","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1055\/s-0040-1718891","article-title":"Rivaroxaban compared to placebo for the treatment of leg superficial vein thrombosis: A randomized trial","volume":"46","author":"C Kearon","year":"2020","journal-title":"Semin Thromb Hemost"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.ejvs.2021.04.015","article-title":"Management and outcomes of patients with isolated superficial vein thrombosis under real life conditions (INSIGHTS-SVT)","volume":"62","author":"R Bauersachs","year":"2021","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"e3","DOI":"10.1111\/bjh.17757","article-title":"Rivaroxaban for the treatment of superficial vein thrombosis, experience at King's College Hospital","volume":"196","author":"R E Clapham","year":"2022","journal-title":"Br J Haematol"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.jtha.2023.10.017","article-title":"Incidence of venous thromboembolism, recurrence, and bleeding after isolated superficial vein thrombosis: findings from the Venous Thrombosis Registry in \u00d8stfold Hospital","volume":"22","author":"C T J\u00f8rgensen","year":"2024","journal-title":"J Thromb Haemost"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.ejim.2024.01.017","article-title":"Treatment with direct oral anticoagulants (DOACs) and secondary prophylaxis in patients affected by multiple episodes of superficial venous thrombosis","volume":"122","author":"A Lagan\u00e0","year":"2024","journal-title":"Eur J Intern Med"}],"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2788-3034.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T22:57:08Z","timestamp":1785365828000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2788-3034"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,15]]},"references-count":12,"journal-issue":{"issue":"08","published-online":{"date-parts":[[2026,7,29]]},"published-print":{"date-parts":[[2026,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2788-3034","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1,15]]},"published":{"date-parts":[[2026,1,15]]}}}