{"id":22777,"date":"2025-11-07T12:57:44","date_gmt":"2025-11-07T17:57:44","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&p=22777"},"modified":"2025-11-11T13:18:19","modified_gmt":"2025-11-11T18:18:19","slug":"association-of-direct-oral-anticoagulant-anticonvulsant-co-prescription-with-clinical-outcomes-in-older-adults","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-of-direct-oral-anticoagulant-anticonvulsant-co-prescription-with-clinical-outcomes-in-older-adults\/","title":{"rendered":"Association of direct oral anticoagulant-anticonvulsant co-prescription with clinical outcomes in older adults: a population-based cohort study"},"content":{"rendered":"

Background<\/strong> \u2014 Anticonvulsants vary in their theoretical propensity to interact with direct oral anticoagulants (DOACs). Co-prescription may reduce DOAC efficacy and increase risk of thromboembolism.<\/p>\n

Methods<\/strong> \u2014 We undertook three cohort studies using administrative healthcare data for Ontarians aged 66 years and older who were using a DOAC and newly prescribed one of three groups of anticonvulsants with declining theoretic propensity for interaction: group 1 (strongly interacting); group 2 (mildly interacting); and group 3 (potentially interacting). Each cohort was compared with a reference group of patients who were newly co-prescribed a DOAC with a presumed non-interacting anticonvulsant. The primary outcome was hospitalization for thromboembolism. Secondary outcomes were major bleeding, death, and a composite of thromboembolism or death. Analysis was by propensity score inverse probability of treatment weighted (IPTW) competing risk Fine-Gray regression models.<\/p>\n

Results<\/strong> \u2014 We studied 17,325 patients: 878 in group 1; 313 in group 2; 943 in group 3; and 15,191 in the reference group. After IPTW, we did not observe an association with thromboembolism or major bleeding in groups 1-3. The Cox proportional HR for death in those prescribed group 1 anticonvulsants was 2.21 (95% CI, 1.77-2.75).<\/p>\n

Conclusion<\/strong> \u2014 In patients using a DOAC and newly prescribed a group 1, 2 or 3 anticonvulsant, we did not observe an increased risk of thromboembolism. In patients newly co-prescribed a DOAC with a group 1 anticonvulsant, the observed increased risk of death is likely due to residual confounding.<\/p>\n","protected":false},"excerpt":{"rendered":"

Background \u2014 Anticonvulsants vary in their theoretical propensity to interact with direct oral anticoagulants (DOACs). Co-prescription may reduce DOAC efficacy and increase risk of thromboembolism. Methods \u2014 We undertook three cohort studies using administrative healthcare data for Ontarians aged 66 years and older who were using a DOAC and newly prescribed one of three groups […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[17,56],"migration-helper-qa-sample-set":[],"class_list":["post-22777","journal_article","type-journal_article","status-publish","hentry","topic-older-people","topic-pharmacoepidemiology-and-drug-safety"],"acf":{"citation":"Carlin S, Holbrook AM, Candeloro M, Nguyen F, Paterson JM, Douketis J. J Thromb Haemost<\/em>. 2025; S1538-7836(25)00727-5. Epub 2025 Nov 7.","source_url":"https:\/\/doi.org\/10.1016\/j.jtha.2025.10.027","ices_scientist":[1100],"site":[6737],"research_program":[6746],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"\nICES | Association of direct oral anticoagulant-anticonvulsant co-prescription with clinical outcomes in older adults: a population-based cohort study<\/title>\n<meta name=\"description\" content=\"Background \u2014 Anticonvulsants vary in their theoretical propensity to interact with direct oral anticoagulants (DOACs). 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