Saturday, 23 February 2019 11:02

Anticoagulation news items. Week commencing 18th February 2019

Concomitant Use of Direct Oral Anticoagulants with Antiplatelet Agents and the Risk of Major Bleeding in Patients with Nonvalvular Atrial Fibrillation

American Journal of Medicine

Study (n=14,407) found during median 1.6 months follow-up, concomitant DOAC-antiplatelet (vs. Vit K antagonist-antiplatelet) linked to similar GI bleeding risk but decreased intracranial bleed risk (HR 0.46; 95% CI, 0.24-0.91) and other major bleeding (0.68; 95% CI, 0.51-0.91).

 

Turoctocog alfa pegol for Haemophilia A approved for use in the US

Biospace Inc.

Approval was on the basis of a trial which found that turoctocog alfa pegol provided effective prophylaxis and that patients were able to maintain a low median annualised bleeding rate of 1.18 on maintenance dosing. It is currently under regulatory review for use in the EU.

 

Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis

New England Journal of Medicine

This RCT in which 2003 adults in ICU were randomised to either pharmacologic thromboprophylaxis alone or in combination with intermittent pneumatic compression, reports no statistically significant difference in incident proximal lower-limb DVT, or death from any cause at 90 days.

 

Efficacy and Safety of Apixaban versus Warfarin in Patients with Atrial Fibrillation and Extremes in Body Weight: Insights from the ARISTOTLE Trial

Circulation

Post-hoc analysis involving 1985 patients ≤60kg, 15,172 patients in the mid-range weight group and 982 patients >120kg reports treatment effect of apixaban vs warfarin for efficacy outcomes of stroke/systemic embolism, all-cause death, or MI was consistent across weight spectrum.

 

Intracerebral haemorrhage during alemtuzumab administration

The Lancet

In this letter, the authors describe the presentation of patients with intracerebral haemorrhage, and suggest that patients whose mean systolic BP increases >20mmHg (or 20% or more throughout the infusion period), might be at high risk of intracranial haemorrhage.

 

 

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