Safety and efficacy of direct oral anticoagulants in patients with liver cirrhosis: a meta-analysis.

ABSTRACT:

Background

Direct oral anticoagulants (DOACs) are the standard of care for treatment of venous thromboembolism and stroke prophylaxis in atrial fibrillation. Since patients with Child-Pugh (CP) B or C liver cirrhosis are underrepresented in trials, the safety of DOACs in this population is unclear.

Objectives

This study synthesized primary evidence on the safety profile of DOACs in patients with advanced liver cirrhosis.

Methods

A literature search of MEDLINE and Embase from inception to October 2025 identified randomized and nonrandomized cohort studies comparing DOAC with vitamin K antagonists or low-molecular-weight heparin in patients with liver cirrhosis. Screening and data collection were conducted in duplicate. The primary outcome was major bleeding defined by

SUBMITTER: Tham D 

PROVIDER: S-EPMC12804106 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature