Friday, 19 July 2019 17:54

Anticoagulation news items. Week commencing 15th July 2019

Continuous Anticoagulation and Cold Snare Polypectomy Versus Heparin Bridging and Hot Snare Polypectomy in Patients on Anticoagulants With Subcentimeter Polyps: A Randomized Controlled Trial

Annals of Internal Medicine

This RCT (n=184) suggests small colorectal polyps may be resected safely with cold-snare polypectomy while oral anticoagulation continues, compared to heparin bridging with hot-snare polypectomy, and was associated with a lower incidence of major bleeding.

 

Benefits and Harms of Oral Anticoagulant Therapy in Chronic Kidney Disease: A Systematic Review and Meta-analysis

Annals of Internal Medicine

Review of 45 RCTs (n=34,082) concludes in early-stage CKD, non–vitamin K oral anticoagulants (NOACs) had benefit–risk profile superior to that of vitamin K antagonists (VKAs). For advanced CKD or ESKD, there was insufficient evidence to establish benefits or harms of VKAs v NOACs.

 

Rivaroxaban (Xarelto▼): reminder that 15 mg and 20 mg tablets should be taken with food

Medicines and Healthcare products Regulatory Agency

MHRA has received a small number of reports suggesting lack of efficacy (thromboembolic events) in patients taking 15 mg or 20 mg rivaroxaban on an empty stomach. Healthcare professional are advised to remind patients to take 15 mg or 20 mg rivaroxaban tablets with food.

 

Direct Acting Oral Anticoagulants (DOACs) in Renal Impairment: Practice Guide to Dosing Issues

Specialist Pharmacy Service

This paper explains the background to dosing decisions for DOACs in patients with impaired renal function and focusses on the use of DOACs in patients with AF. It provides case study examples from current clinical practice and is intended as a practice aid.

 

 

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