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Comment & Response
ܲԱ25, 2014

Therapies for Venous Thromboembolism

Author Affiliations
  • 1Yale University School of Medicine, New Haven, Connecticut
JAMA. 2014;311(24):2543. doi:10.1001/jama.2014.6114

To the Editor The review by Dr Wells and colleagues1 on the treatment of venous thromboembolism requires some clarifications. Table 1 in the article summarized new oral anticoagulants as treatment options for venous thromboembolism. However, only rivaroxaban is currently approved in both the United States and Europe, dabigatran was recently approved by the US Food and Drug Administration (FDA), and apixaban awaits approval by both the FDA and the European Medicines Agency.

For thrombolysis for submassive pulmonary embolism, Wells et al1 mentioned that the Pulmonary Embolism Thrombolysis (PEITHO) trial2 did not show a mortality reduction, but they did not mention that the PEITHO trial was not designed for that purpose. It was in fact positive for its primary end point, a composite of death or hemodynamic collapse within 7 days (odds ratio, 0.44). Furthermore, 23 patients in the placebo group vs 4 in the intervention group received rescue thrombolysis (P &; .001).

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