Treatment with concomitant non-vitamin K antagonist oral anticoagulants (NOACs) and oral glucocorticoids is associated with an elevated risk of gastrointestinal bleeds, according to findings from one of the few major studies to explore the issue, cardiologists say.

The results suggest that patients prescribed the dual therapy may require close monitoring, particularly those with an increased susceptibility to bleeding and on high doses of the steroids, the researchers say.

Oral glucocorticoids are already known to increase the risk of gastrointestinal (GI) bleeds when prescribed alongside vitamin K antagonists, but the interaction with NOACs is less well understood, they say.

Writing in the journal Heart, the Copenhagen University Hospital-led team report that not only does this association apply for the newer class of anticoagulants, but there is also evidence of a dose-response relationship.