LettersFebruary 2022
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    IN RESPONSE: We agree that the risk for major bleeding events is highest shortly after initiation of anticoagulant therapy, particularly in the first 3 months of treatment. However, the patient population of our meta-analysis was composed of those with a first unprovoked venous thromboembolism who had already completed at least 3 to 6 months of initial anticoagulation.

    Although we acknowledge the concern about potential “depletion of susceptibles bias” (that is, bleeding events becoming less frequent over longer periods of time), results from our meta-analysis do not suggest that is the case. As shown in our analysis among patients receiving extended ...