A Comparison of the Direct Oral Anticoagulants in Treatment of Acute Deep Vein Thrombosis for Primary Care Physicians

Management of acute deep vein thrombosis (DVT) is within the scope of primary care physicians. When indicated, treatment is essential to prevent life-threatening pulmonary embolism (PE). Parenteral anticoagulation followed by warfarin has been considered the standard of care. Four pivotal trials have established a role for direct oral anticoagulants (DOACs) in acute treatment of DVT. Dabigatran, rivaroxaban, apixaban, and edoxaban have been shown to have similar efficacy compared to warfarin in the management of acute DVT. These new agents offer similar, or superior, bleeding risks and have distinctive properties that may affect clinicians’ prescribing have distinctive properties that practices. Here we summarize the key findings of these four trials and offer some insights as to which agents may be better suited to specific clinical scenarios. *Corresponding author Nathalie S. Ranger, Department of Family Medicine, Queens University, Kingston, Ontario, Canada, Email: