The Curbsiders Internal Medicine Podcast UNLOCKED PATREON #60 Anticoagulation DVT/PE
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Dec 29, 2025 In this enlightening discussion, experts explore the nuances of anticoagulation for venous thromboembolism. They dive into the pros and cons of DOACs, highlighting the preference for apixaban due to safety considerations. The hosts share insights on dosing strategies, duration of therapy, and when to conduct hypercoagulable testing. They tackle management of distal DVT and address special cases like bariatric patients. Plus, discover their exciting recommendations, including gripping novels and a visually stunning video game!
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Hosts Open With Food Puns
- Matthew Watto and Paul Nelson-Williams trade corny food puns at the top of the episode for lighthearted rapport.
- The hosts use brief humor before launching into clinical discussion.
Default To Apixaban For Many VTE Cases
- Favor apixaban over rivaroxaban for most VTE patients, especially with renal impairment or higher bleeding risk.
- Use rivaroxaban when renal function is intact and insurance or patient factors make it preferable.
Why Starter DOAC Doses Exist
- Initial higher-dose 'starter' DOAC regimens exist because trials used them and to get patients therapeutic quickly.
- The highest recurrence risk is front-loaded early after clot, so early intensified dosing makes sense.