Friday, 04 March 2016 20:52

Anticoagulation news items. Weeks commencing 29th February 2016

Effect of oral factor Xa inhibitor and low-molecular-weight heparin on surgical complications following total hip arthroplasty

Thrombosis and Haemostasis

This study (n=351) found no significant differences between rivaroxaban (RV) and enoxaparin (EN) in surgical wound complications, with similar rates of venous thromboembolic (VTE) events. Only wound oozing continued longer in RV/EN than in placebo group for patients <60 years.

 

Outcomes and costs of left atrial appendage closure from randomized controlled trial and real-world experience relative to oral anticoagulation

European Heart Journal
Treatment with this device can reduce risk of stroke, major bleeding, and death vs. other therapeutic strategies, which may offset additional upfront costs of device. Benefits are most apparent in those with higher baseline thromboembolic risk or unsuitable for anticoagulation.

 

Is the HAS-BLED score useful in predicting post-extraction bleeding in patients taking warfarin? A retrospective cohort study

BMJ Open

Japanese study of 258 cases (462 teeth) who had undergone tooth extraction (TE) whilst on warfarin found HAS-BLED score alone could not predict post TE bleeding. Concomitant use of antiplatelets was a risk factor. No episodes of bleeding required more than local measures.

 

New product: Octaplex (blood coagulation factors IX, II, VII, and X) 1000IU

electronic Medicines Compendium

This is licensed for treatment of bleeding and perioperative prophylaxis of bleeding in acquired deficiency of prothrombin complex coagulation factors (CFs), and in congenital deficiency of vitamin K dependent CFs II and X when purified specific CF product is not available.

 

New product: Exembol (argatroban) Multidose 100 mg/ml concentrate for solution for infusion

electronic Medicines Compendium

Exembol is licensed as anticoagulation in adults with heparin-induced thrombocytopenia type II who need parenteral antithrombotic therapy. Diagnosis should be confirmed by heparin induced platelet activation assay or equivalent. However, such confirmation must not delay treatment.

 

NIHR Signal: Extending anticoagulant treatment beyond three months reduces the risk of recurrent blood clots

National Institute for Health Research Signal

This commentary discussing a systematic review of 7 studies (n=6778), which found that warfarin, NOACs and aspirin all significantly reduced the rate of recurrent clots in patients treated for >3 months, notes a non-significant trend towards major bleeding with active vs. placebo.

 

Compression Stockings for Preventing the Postthrombotic Syndrome in Patients with Deep Vein Thrombosis

American Journal of Medicine

This meta-analysis of 5 RCTs (n=1418) suggests no effect of elastic compression stockings on postthrombotic syndrome. Effects however remain uncertain as results differed substantially, and there was significant heterogeneity between trials.

 

 

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