Friday, 19 May 2017 20:59

Anticoagulation news items. Week commencing 13th May 2017

Unfractionated heparin versus low molecular weight heparins for avoiding heparin‐induced thrombocytopenia in postoperative patients

Cochrane Database of Systematic Reviews

Updated review of 3RCTs (n=1398) demonstrated low-quality evidence of a lower incidence of heparin-induced thrombocytopenia (HIT), and HIT complicated by venous thromboembolism, in postoperative patients undergoing thromboprophylaxis with LMWH compared with UFH.

 

Influence of Direct Oral Anticoagulants on Rates of Oral Anticoagulation for Atrial Fibrillation

Journal of the American College of Cardiology

Study (n=655,000; CHA2DS2-VASc >1) in US found introduction of DOACs into routine practice linked to improved rates of overall oral anticoagulant use (from 52.4% to 60.7%; p<0.01; warfarin use decreased 52.4% to 34.8%; DOAC use increased 0% to 25.8%) but significant gaps remain.

 

Anticoagulation in patients with isolated distal deep vein thrombosis: a meta-analysis

Journal of Thrombosis and Haemastasis

Review of 20 studies (n= 2,936) found that anticoagulation (therapeutic or prophylactic) reduced to the risk of VTE vs no anticoagulation (OR 0.5, 95% CI 0.31-0.79). There was no significant difference in major bleeding risk (OR 0.64, 0.15-2.73).

 

FDA grant fast track designation for SB-525 gene therapy for haemophillia

PharmaTimes

SB-525 uses a recombinant adeno-associated virus (rAAV) to deliver a human Factor VIII cDNA construct. This treatment also has orphan designation in the US. EU development plans are unknown.

 

Revised SPC: Pradaxa (dabigatran etexilate) hard capsules – all strengths

electronic Medicines Compendium

The colour of Pradaxa caps have been changed according to dosage strength, as part of the worldwide harmonisation process.

 

Risk Minimisation materials for Pradaxa capsules (dabigatran etexilate): Prescriber guides for various indications and Patient Alert Card

electronic Medicines Compendium

The Prescriber guide for primary prevention of venous thromboembolic events following elective hip or knee replacement surgery provides recommendations for orthopaedic use with the aim of minimising risk of bleeding, and providing guidance on how to manage that risk.

 

Benefit of switching dual antiplatelet therapy after acute coronary syndrome: the TOPIC (timing of platelet inhibition after acute coronary syndrome) randomized study

European Heart Journal

RCT (n=645) reports switching dual antiplatelet therapy (DAPT) from aspirin + newer P2Y12 blocker to clopidogrel after 1 month results in occurrence of primary endpoint (composite CV death, urgent revascularisation, stroke and bleeding) of 26.3% vs 13.4% respectively (P < 0.01).

 

Educational Risk Minimisation Materials for Clexane (enoxaparin sodium)

Sanofi UK

Dear Healthcare Professional" letter notes that enoxaparin is expressed both in international units (IU) of anti-Xa activity and in milligrams (mg); and that its use in severe renal impairment is not recommended. There is also further clarification on dose regimens for DVT/PE.

 

 

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