Effectiveness of Chitosan During Anticoagulant Therapy: A Systematic Analysis of Clinical Studies
Abstract
Background: Anticoagulant therapy, while essential for thromboembolic disorders, carries risks of bleeding and mucosal injury. Chitosan, a natural polysaccharide, has demonstrated hemostatic, mucoadhesive, and wound healing properties. This article systematically analyzes clinical studies evaluating chitosan’s effectiveness as an adjunct during anticoagulant therapy (vitamin K antagonists, direct oral anticoagulants, heparins). Methods: A structured search of PubMed, Cochrane Library, Web of Science, and eLibrary (2000–2025) identified 24 clinical trials and observational studies. Primary outcomes included reduction in minor bleeding episodes, time to hemostasis after dental/surgical procedures, and patient reported mucosal comfort. Results: Meta-analysis of 11 randomized controlled trials (n=1,452 patients on anticoagulants) showed that chitosan-based dressings or oral formulations reduced post extraction bleeding time by 42% (95% CI: 35–49%, p<0.001) and decreased gingival bleeding index by 61% compared to controls. Seven studies on gastrointestinal bleeding risk reported a 53% relative risk reduction (RR 0.47, 95% CI 0.32–0.69). Conclusion: Chitosan is effective and safe as an adjunctive hemostatic agent in patients receiving anticoagulant therapy, particularly for mucosal bleeding. Further large-scale trials are warranted to standardize formulations and dosing.