Risk of Haemorrhage from Pharmacodynamic Interactions with Oral Anticoagulants: A Population-Based Study in Catalonia, Spain

Risk of Haemorrhage from Pharmacodynamic Interactions with Oral Anticoagulants: A Population-Based Study in Catalonia, Spain | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 21 January 2026 V1 Latest version Share on Risk of Haemorrhage from Pharmacodynamic Interactions with Oral Anticoagulants: A Population-Based Study in Catalonia, Spain Authors : Ainhoa Gomez Lumbreras 0000-0002-3916-0402 , Dan Ouchi , Guim Arbona Ricart , Alba Álamo Alonso , Judit Maymó Calatayud , Carles Vilaplana-Carnerero , Maria Giner-Soriano 0000-0003-3750-9233 [email protected] , and Rosa Morros Authors Info & Affiliations https://doi.org/10.22541/au.176902407.78265547/v1 166 views 72 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract not-yet-known not-yet-known not-yet-known unknown Introduction : Direct oral anticoagulants (DOAC) are widely used by elderly populations that are often exposed to polypharmacy. Pharmacodynamic drug interactions (PD-DDI) may increase the risk of haemorrhage in patients on DOAC. Methods : A case-cross over and cohort study designs were used to assess the risk of haemorrhage (gastrointestinal and intracranial haemorrhage) due to PD-DDI on patients exposed to DOAC and concomitantly to nonsteroidal anti-inflammatory drugs (NSAIDs), antiplatelet agents, corticosteroids and antidepressants inhibiting serotonin reuptake. Using the Health Research and Innovation Data Analysis Programme (PADRIS) of the Health Department of the Government of Catalonia, Spain a conditional logistic regression analysis showing the odds ratio (OR) and 95% confidence interval (95%) in the case-crossover design and a propensity score match (PSM) in the case of the cohort design were run. Results : Case-crossover design: A total of 2,422 patients were on DOAC and experienced a haemorrhagic event. PD-DDI risk of haemorrhage for NSAID showed an OR 2.89 (05% CI 1.91 - 4.37), a OR 1.95 (95% CI 1.30 - 2.93) for antiplatelets and OR 1.88 (95% CI 1.30 - 2.72) for corticosteroids. There were no associations with intracranial haemorrhage. Cohort design: After PSM the cohort of 43,892 patients on a DOAC showed 21,943 exposed to a PD-DDI. NSAIDs PD-DDI showed a threefold risk of haemorrhage (OR 2.75, 95% CI 1.22 - 6.18) and gastrointestinal specific too (OR 3.6, 95% CI 1.34 - 9.70), with no risk of intracranial haemorrhage. Conclusions : DOAC have increased risk of haemorrhage when concomitantly exposed to drugs that also show risk of haemorrhage (PD-DDI). Clinicians may need to personalize according to the PD-DDI risk of haemorrhage in high-risk patients, this is according to their personal history and need of concomitant used other medications. Supplementary Material File (pds-26-0059-file001.docx) Download 102.09 KB File (pds-26-0059-file005.docx) Download 27.78 KB Information & Authors Information Version history V1 Version 1 21 January 2026 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords anticoagulants database management systems drug interactions drug-related side effects and adverse reactions haemorrhage pharmacology Authors Affiliations Ainhoa Gomez Lumbreras 0000-0002-3916-0402 The University of Utah College of Pharmacy View all articles by this author Dan Ouchi Institut d'Investigacio en Atencio Primaria de Salut Jordi Gol View all articles by this author Guim Arbona Ricart Universitat Autònoma de Barcelona View all articles by this author Alba Álamo Alonso Universitat Autònoma de Barcelona View all articles by this author Judit Maymó Calatayud Universitat Autònoma de Barcelona View all articles by this author Carles Vilaplana-Carnerero Generalitat de Catalunya Servei Catala de la Salut View all articles by this author Maria Giner-Soriano 0000-0003-3750-9233 [email protected] Institut d'Investigacio en Atencio Primaria de Salut Jordi Gol View all articles by this author Rosa Morros Institut d'Investigacio en Atencio Primaria de Salut Jordi Gol View all articles by this author Metrics & Citations Metrics Article Usage 166 views 72 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Ainhoa Gomez Lumbreras, Dan Ouchi, Guim Arbona Ricart, et al. Risk of Haemorrhage from Pharmacodynamic Interactions with Oral Anticoagulants: A Population-Based Study in Catalonia, Spain. Authorea . 21 January 2026. DOI: https://doi.org/10.22541/au.176902407.78265547/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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