Tuesday, 08 April 2014 08:36

Anticoagulation news items. Week commencing 31st March 2014

Recent Advances in Antidotes for Direct Oral Anticoagulants: Their Arrival Is Imminent

Canadian Journal of Cardiology

Several antidotes for direct oral anticoagulants are being developed and recently presented data have raised hopes that their introduction into clinical practice is imminent. In this article, the authors review the latest advances in their development.

 

FDA approves first long-acting recombinant coagulation Factor IX concentrate (Alprolix) for patients with haemophilia B

Biospace Inc.

This has been approved in US for control and prevention of bleeding episodes, perioperative management and routine prophylaxis, in patients with haemophilia B. It was developed using Fc fusion and thus has a more prolonged circulation in body which extends time between infusions.

 

Lack of Concordance between Empirical Scores and Physician Assessments of Stroke and Bleeding Risk in Atrial Fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) Registry

Circulation

This analysis of 10,094 AF patients found little agreement between provider-assessed risk and empirical stroke and bleeding risk scores in AF. These differences may partly explain current divergence of anticoagulation treatment decisions from guideline recommendations.

 

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

Circulation

These US guidelines for management of atrial fibrillation cover: • Pathophysiology • Clinical evaluation: • Prevention of thromboembolism • Rate control • Rhythm control • Specific patient groups • Evidence gaps and future research directions

 

Combined oral contraceptives: venous thrombosis

Cochrane Database of Systematic Reviews

All COCs investigated in this analysis were linked to increased risk of VTE. The effect size depended both on progestogen used and dose of ethinylestradiol (EE). Thus COCs with lowest possible dose of EE and good compliance should be prescribed, i.e. 30 μg EE with levonorgestrel.

 

Preconception low-dose aspirin and pregnancy outcomes: results from the EAGeR randomised trial

The Lancet

In women with 1 or 2 losses, there was no difference in live birth rate (309/535 for aspirin vs 286/543 for placebo; p=0•0984). However, in women with 1 loss at less than 20 weeks gestation, there was a significant difference (151/242 for aspirin vs 133/250 for placebo; p=0•0446)

 

Vibropulse for cellulitis or venous leg ulcers

Midlands Medicines

This is an evidence based summary of Vibropulse™, a device that utilises cycloidal vibration therapy and is prescribable on an FP10 for cellulitis or venous leg ulcers. The review concludes that there are currently insufficient data in this area to recommend its use.

 

 

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