Risk reductions greater than 80%
Anticoagulants (warfarin), the mainstay of VTE treatment, are very effective at preventing VTE extension and VTE recurrence, with relative risk reductions greater than 80%. Anticoagulants are also the leading drug class linked to drug-related adverse events (e.g. life-threatening bleeding) and impose patient burden from the need for injections, frequent laboratory monitoring, and lifestyle or dietary modifications. Thus, VTE treatment needs to be individualised to optimally balance efficacy and safety. Individualisation increases treatment complexity, which poses knowledge translation (KT) challenges that can be met by developing and validating clinical decision rules to guide clinicians and patients. A number of new or direct oral anticoagulants to prevent and treat VTE have been approved in the last few years, and others are in the development or testing phases. The long-term efficacy, safety, cost-effectiveness, and comparative effectiveness of these drugs are yet unknown, and many hospital and community physicians still have limited experience with their use. Also, only selected patients were included in the trials that led to regulatory approval of these drugs, leaving key knowledge gaps about the role of new therapies in many important subgroups (obese patients, those with renal dysfunction, pregnant or lactating women, frail elderly, and cancer patients) for the research community to address. Other important knowledge gaps include inadequately understood causal factors for first and recurrent VTE, inconsistent use of proven measures to prevent VTE, limited community expertise in diagnosing and managing VTE and its complications particularly also when it comes to missing a diagnosis, and limited knowledge of VTE among the general public. Taken together, it is evident that VTE is a significant cause of death, short-term sickness, long-term disability and economic burden to the Dutch population, and that further clinical research, from early phase studies to KT, is needed to address important knowledge gaps and improve patient outcomes.National, patient-oriented program
With the rising incidence of VTE and, for the first time in 60 years, the availability of numerous new oral drug options besides warfarin to treat VTE, it is an opportune time to take action to address this important public health issue in a focused, highly organized and patient centered manner. We have therefore initiated Dutch Thrombosis Network (DTN), a national, patient-oriented program centered on thrombosis related research, health care innovation, patient empowerment, training for physicians and students, and knowledge transfer.
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Dutch Thrombosis Network (DTN) is an independent, not-for-profit network of academic and nonacademic clinical and basic researchers in thrombosis.
DTN exists to promote national collaboration between academic and nonacademic researchers that conduct venous thromboembolism (VTE) related clinical research, and to enhance the profile, science, and impact of investigator-led VTE clinical research. More »
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