Figure 21 shows lists some of the key trials for each of the NOACs for use of anticoagulation in the setting of venous thromboembolism (VTE),[19-22] with the 3 primary endpoints in this setting being recurrent VTE, major bleeding, and non-major but nonetheless clinically relevant bleeding.

Taken together the results of the studies shown in the Figure reveal that, as with AFib, the NOACs appear to perform at least as well as warfarin or another comparator anticoagulant or placebo with respect to preventing recurrent VTE.  There may also be a reduction in both major bleeding and also (in many cases) in clinically-relevant non-major bleeding with the NOACs as opposed to warfarin.  Thus, versus injectable anticoagulants, or transitioning from heparin or enoxaparin (low-molecular weight heparin) to warfarin, or whatever other standard comparator might have been used in these trials, the NOACs represent a therapy that is a bit easier to use but with efficacy that is at least matching that of warfarin and with a major bleeding risk that appears to be less. 

Overall, it seems that, as in AFib, for physicians who treat patients with VTE, having several new options for oral anticoagulation in patients who are eligible and do not have contraindications appears to be a major advance.