Sunday, 11 May 2014 10:08

Anticoagulation news items. Week commencing 5th May 2014

Prasugrel plus bivalirudin vs. clopidogrel plus heparin in patients with ST-segment elevation myocardial infarction

European Heart Journal
This RCT (n=548 of 1240 planned patients) was unable to demonstrate significant differences in net clinical outcome between prasugrel + bivalirudin and clopidogrel + heparin at 30 days, though results must be interpreted with caution in view of premature termination of trial.

 

Antithrombotic treatment in patients with heart failure and associated atrial fibrillation and vascular disease: A nationwide cohort study

Journal of the American College of Cardiology
Study (n=37,464) found that in AF patients with co-existing HF and vascular disease, adding single antiplatelet on top of VKA therapy is not associated with additional benefit on thromboembolic or coronary risk, but notably increased bleeding risk (HR 1.31; 95% 1.09-1.57).

 

Edoxaban: a focused review of its clinical pharmacology

European Heart Journal
The review discusses effects on coagulation parameters and on bleeding in animal models, use of combination therapy in animal models, pharmacokinetics and link to bleeding, pharmacodynamics, metabolism, drug/food interactions; and reversal of anticoagulant effects.

 

Low molecular weight heparin for prevention of venous thromboembolism in patients with lower-leg immobilization

Cochrane Database of Systematic Reviews
Review of 6 RCTs (n=1490) found use of LMWH in outpatients significantly reduces VTE when immobilisation of lower leg is required (OR 0.49; 95% CI, 0.34-0.72). Complications of major bleeding were extremely rare (0.3%) and there were no reports of heparin-induced thrombocytopenia.

 

FDA requests further information for investigational antiplatelet agent cangrelor

Biospace Inc.
The US FDA has issued a Complete Response Letter for the investigational intravenous antiplatelet agent cangrelor requesting further information for the PCI and BRIDGE indications. Cangrelor is also being reviewed by the European Medicines Agency.

 

 

 

 

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