Semin Thromb Hemost 2020; 46(08): 919-931
DOI: 10.1055/s-0040-1718892
Review Article

Research Trends in Anticoagulation Therapy over the Last 25 Years

Mustafa K. Mian
1   Royal Melbourne Hospital Clinical School, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
,
Subhashaan Sreedharan
1   Royal Melbourne Hospital Clinical School, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
,
Neeraj S. Limaye
,
Chris Hogan
2   Department of Haematology, Austin Hospital, Heidelberg, Victoria, Australia
3   Department of Haematology, Royal Melbourne Hospital, Parkville, Victoria, Australia
,
Jai N. Darvall
4   Departments of Intensive Care and Anaesthesia/Pain Management, Royal Melbourne Hospital, Parkville Victoria, Australia
5   Centre for Integrated Critical Care, University of Melbourne, Parkville, Victoria, Australia
› Author Affiliations

Abstract

A large volume of literature has become available to practitioners prescribing anticoagulants. The aim of this study was to analyze the bibliometric characteristics of the top 100 most cited articles related to anticoagulation over the past 25 years, with special consideration to impact of direct or “nonvitamin K antagonist” oral anticoagulants (NOACs) compared with vitamin K antagonists. A bibliometric analysis of the 100 most cited journal articles related to anticoagulants published between 1994 and 2019 was performed in April 2019. The top 100 articles by citation count were analyzed to extract bibliometric data related to journal title, impact factor, year of publication, place of publication, anticoagulant studied, indication for anticoagulation, study design, and conflicts of interest. The median (interquartile range) number of citations per article was 806 (621–1,085). The anticoagulant most frequently researched was warfarin (37%). NOAC publications (21%) grew at a relative rate of 3.4 times faster compared with all publications. The indication most commonly researched was venous thromboembolism (26%). Eighty articles constituted level I or II evidence, with randomized controlled trials the most common type of study (74). A financial conflict of interest was declared in 87% of articles with private, for-profit organizations the most common source of funding (26%). In summary, top research related to anticoagulation is highly impactful but may be at risk of sponsorship bias. High-level evidence for NOACs continues to expand across a range of indications with citation metrics likely to soon approach or surpass that of older drugs.



Publication History

Article published online:
23 December 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Zion Market Research, Anticoagulants Market by Drug Class (NOACs, Heparin & LMWH, Vitamin K Antagonist, and Others), by Route of Administration (Injectable Anticoagulant and Oral Anticoagulant), and by Application (Stroke, Atrial Fibrillation, Pulmonary Embolism (PE), Deep Vein Thrombosis (DVT), and Others): Global Industry Perspective, Comprehensive Analysis, and Forecast, 2018–2025, New York, USA. 2019. . Available at: https://www.zionmarketresearch.com/market-analysis/anticoagulants-market. Accessed April 20, 2020
  • 2 Warkentin TE, Kelton JG. A 14-year study of heparin-induced thrombocytopenia. Am J Med 1996; 101 (05) 502-507
  • 3 Agnelli G. Current issues in anticoagulation. Pathophysiol Haemost Thromb 2005; 34 (Suppl. 01) 2-9
  • 4 Lee LH. DOACs - advances and limitations in real world. Thromb J 2016; 14 (Suppl. 01) 17
  • 5 Granger CB, Alexander JH, McMurray JJV. ARISTOTLE Committees and Investigators. et al; Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365 (11) 981-992
  • 6 Connolly SJ, Ezekowitz MD, Yusuf S. RE-LY Steering Committee and Investigators. et al; Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361 (12) 1139-1151
  • 7 Schulman S, Kearon C, Kakkar AK. RE-COVER Study Group. et al; Dabigatran versus warfarin in the treatment of acute venous thromboembolism. N Engl J Med 2009; 361 (24) 2342-2352
  • 8 Agnelli G, Buller HR, Cohen A. AMPLIFY Investigators. et al; Oral apixaban for the treatment of acute venous thromboembolism. N Engl J Med 2013; 369 (09) 799-808
  • 9 Roldan-Valadez E, Salazar-Ruiz SY, Ibarra-Contreras R, Rios C. Current concepts on bibliometrics: a brief review about impact factor, Eigenfactor score, CiteScore, SCImago Journal Rank, Source-Normalised Impact per Paper, H-index, and alternative metrics. Ir J Med Sci 2019; 188 (03) 939-951
  • 10 Factor JI, Reports JC. Science edition, Clarivate Analytics. 2020 . Available at: https://jcr.clarivate.com/. Accessed February 17, 2020
  • 11 NHMRC, How to use the evidence: Assessment and application of scientific evidence, 2000 Canberra Biotext. Available at: https://www.nhmrc.gov.au/sites/default/files/documents/reports/clinical%20guidelines/how-to-use-evidence-cp69.pdf. Accessed February 17, 2020
  • 12 Patience GS, Patience CA, Blais B, Bertrand F. Citation analysis of scientific categories. Heliyon 2017; 3 (05) e00300
  • 13 Sweileh WM, Shraim NY, Zyoud SH, Al-Jabi SW. Worldwide research productivity on tramadol: a bibliometric analysis. Springerplus 2016; 5 (01) 1108
  • 14 López-Muñoz F, Alamo C, Rubio G, García-García P, Martín-Agueda B, Cuenca E. Bibliometric analysis of biomedical publications on SSRI during 1980-2000. Depress Anxiety 2003; 18 (02) 95-103
  • 15 Wendelboe AM, Raskob GE. Global burden of thrombosis: epidemiologic aspects. Circ Res 2016; 118 (09) 1340-1347
  • 16 Yaminfirooz M, Ardali FR. Identifying the factors affecting papers' citability in the field of medicine: an evidence-based approach using 200 highly and lowly-cited papers. Acta Inform Med 2018; 26 (01) 10-14
  • 17 Fan P, Gao Y, Zheng M, Xu T, Schoenhagen P, Jin Z. Recent progress and market analysis of anticoagulant drugs. J Thorac Dis 2018; 10 (03) 2011-2025
  • 18 Lippi G, Mattiuzzi C, Adcock D, Favaloro EJ. Oral anticoagulants around the world: an updated state-of-the art analysis. Ann Blood 2018; 3: 49
  • 19 Cherla DV, Viso CP, Holihan JL. et al. The effect of financial conflict of interest, disclosure status, and relevance on medical research from the united states. J Gen Intern Med 2019; 34 (03) 429-434
  • 20 Lippi G, Gosselin R, Favaloro EJ. Current and emerging direct oral anticoagulants: state-of-the-art. Semin Thromb Hemost 2019; 45 (05) 490-501
  • 21 Favaloro EJ, McCaughan G, Mohammed S, Pasalic L. Anticoagulation therapy in Australia. Ann Blood 2018; 3: 48
  • 22 Loo SY, Dell'Aniello S, Huiart L, Renoux C. Trends in the prescription of novel oral anticoagulants in UK primary care. Br J Clin Pharmacol 2017; 83 (09) 2096-2106