Friday, 08 January 2016 19:53

Anticoagulation news items. Weeks commencing 4th January 2016

Post-thrombotic syndrome after catheter-directed thrombolysis for deep vein thrombosis (CaVenT): 5-year follow-up results of an open-label, randomised controlled trial

The Lancet Haematology

In this RCT, 37 patients (43%) allocated to catheter-directed thrombolysis developed post-thrombotic syndrome, v 63 (71%) allocated to control group (compression stockings+anticoagulation, p<0.0001), corresponding to an absolute risk reduction of 28% (NNT=4).

 

Risk of death and stroke associated with anticoagulation therapy after mitral valve repair

Heart

In this cohort study of 2188 patients undergoing mitral valve repair, patients on vitamin K antagonists (VKA) had a lower risk of death/stroke at 3 months (HR=0.28, CI 0.13 to 0.62, p=0.002) without an excess major bleeding risk vs. patients not on VKA post discharge.

 

A population database study of outcomes associated with vitamin K antagonists in atrial fibrillation before DOAC

British Journal of Clinical Pharmacology

In this French cohort study of new vitamin K antagonist (VKA) users with atrial fibrillation (n=3,345) there were 3.8 deaths, 2.8 hospitalisations due to bleeding, 1.6 acute coronary syndrome events and 1.5 acute thrombotic events per 100 patient-years.

 

Dabigatran etexilate and reduction in serum apolipoprotein B

Heart

This data review of 2513 patients in the RE-LY trial showed that dabigatran therapy reduced apolipoprotein B after 3 months treatment by -0.057 g/L and -0.065g/L at low dose (110mg bd) and high dose (150mg bd) respectively whereas no reduction was seen with warfarin.

 

Reversal strategies for non-vitamin K antagonist oral anticoagulants: a critical appraisal of available evidence and recommendations for clinical management

European Heart Journal

Summary: This joint paper covers the risk of bleeding with non-vitamin K antagonist oral anticoagulants and existing reversal strategies including the potential benefit of specific reversal agents.

 

Newer antiplatelet agents in acute coronary syndrome

British Medical Journal

Prasugrel and ticagrelor have more predictable pharmacokinetics than clopidogrel (CP) and are appreciably faster in onset of action. Many cardiologists thus use these 2 agents over CP. This editorial discusses whether prescribing of newer antiplatelets has outpaced the evidence?

 

Long-acting haemophilia B therapy nonacog beta pegol filed for approval in EU 

PharmaTimes

Nonacog beta pegol is a glycopegylated recombinant factor IX with an improved pharmacokinetic profile and 5-times longer half-life than standard factor IX. The filing is based on data from paradigm clinical trial programme of 115 patients with moderate- severe haemophilia B.

 

 

The above records have been identified by UKMi and feature in the NICE Medicines Awareness Service. Further details on this service can be found at:
http://www.evidence.nhs.uk/about-evidence-services/content-and-sources/medicines-information/new-medicines-awareness-services