Among patients with pulmonary embolism (PE), adding a retrievable inferior vena cava filter to anticoagulation offers no benefit over anticoagulation alone, a JAMA study finds.

Nearly 400 French patients hospitalized with acute, symptomatic PE and lower-extremity vein thrombosis were randomized to receive anticoagulation alone or with a retrievable filter. At 3 months, recurrent PE had occurred in six patients (3%) in the filter group versus three (1.5%) in the control group (not a statistically significant difference). All six cases in the filter group and two in the control group were fatal.

Based on older studies, the authors say they had anticipated a much higher rate of recurrent PE — about 8% — in the control group. They write, “We believe that the low rate of events observed … is consistent with contemporary care, indicating that modern management with full-dose anticoagulation therapy is likely very effective even in patients usually considered to be at high risk for recurrence, rendering unnecessary additional therapy such as inferior vena cava filters.”