A meta-analysis of seven retrospective cohort studies found that a full high-dose DOAC lead-in is associated with a lower risk of major bleeding compared with reduced lead-in strategies in venous thromboembolism. The analysis found no significant differences in VTE recurrence or mortality. The study frames a practical dosing question that can affect safety outcomes in anticoagulation protocols, where clinicians balance early thrombosis control against bleeding risk. For hospitals and guideline committees, the finding may support more standardized lead-in dosing practices when data and patient characteristics align with the studied populations. Because the included evidence is retrospective, prospective confirmation would still be needed before broad protocol changes, but the direction of effect is clinically meaningful for real-world bleeding prevention.