{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T13:31:37Z","timestamp":1787232697104,"version":"build-2736575974"},"reference-count":16,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Direct oral anticoagulants (DOACs) are recommended as first-line treatment for acute venous thromboembolism (VTE). The recommended regimen of apixaban and rivaroxaban requires a higher-intensity lead-in phase. However, clinicians may use reduced lead-in strategies due to concerns regarding bleeding risk, planned procedures, or prior parenteral anticoagulation. Recent evidence indicates that reduced lead-in dosing may provide comparable clinical outcomes compared to the recommended full lead-in dosing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this study, recent observational studies comparing reduced versus full lead-in apixaban or rivaroxaban therapy in acute VTE were systematically synthesized. Eligible studies included those involving adults treated with apixaban or rivaroxaban in which the lead-in duration was compared. Outcomes assessed included recurrent VTE, bleeding, and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine studies were included in this systematic review; reduced lead-in therapy did not increase VTE recurrence compared with full lead-in regimens. In addition, in these studies, no significant difference was found in major bleeding, clinically relevant non-major bleeding, and mortality across all lead-in strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Evidence demonstrates that reduced lead-in therapy may be both safe and effective in selected patients, particularly those previously treated with therapeutic parenteral anticoagulation. However, current evidence remains observational and heterogeneous. A target trial emulation is required to define optimal lead-in duration and guide patient-specific dosing strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10760296261452847","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:53:07Z","timestamp":1787061187000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reduced Versus Full Lead-In Apixaban or Rivaroxaban in Acute Venous Thromboembolism: A Systematic Review"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2308-8407","authenticated-orcid":false,"given":"Majed S.","family":"Al Yami","sequence":"first","affiliation":[{"name":"College of Pharmacy at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS)"},{"name":"King Abdullah International Medical Research Center (KAIMRC)"},{"name":"Department of Pharmacy, Ministry of National Guard Health Affairs"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2021.07.055"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1207541"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1700518"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12010199"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-022-02641-5"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.2350"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/08971900251313649"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tru.2025.100199"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/87551225251326436"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-025-01993-1"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-025-03181-4"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-025-03199-8"},{"key":"e_1_3_5_14_2","volume-title":"Newcastle\u2013Ottawa Quality Assessment Scale (NOS)","author":"Wells GA","unstructured":"Wells GA, Shea B, O\u2019Connell D, et al. Newcastle\u2013Ottawa Quality Assessment Scale (NOS). Ottawa Hospital Research Institute. Available online: https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp. Accessed on 4 February 2026."},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_5_16_2","unstructured":"Food and Drug Administration (FDA). Eliquis (apixaban) Prescribing Information. Revised 04\/2025. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2025\/220073s000lbl.pdf"},{"key":"e_1_3_5_17_2","unstructured":"Food and Drug Administration (FDA). Xarelto (rivaroxaban) Prescribing Information. Revised 06\/2025. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2025\/022406s044 215859s005lbl.pdf"}],"container-title":["Clinical and Applied Thrombosis\/Hemostasis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296261452847","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10760296261452847","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296261452847","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T13:16:51Z","timestamp":1787231811000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10760296261452847"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":16,"alternative-id":["10.1177\/10760296261452847"],"URL":"https:\/\/doi.org\/10.1177\/10760296261452847","relation":{},"ISSN":["1076-0296","1938-2723"],"issn-type":[{"value":"1076-0296","type":"print"},{"value":"1938-2723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"10760296261452847"}}