Sunday, 22 June 2014 12:18

Anticoagulation news items. Week commencing 16th June 2014

Atrial fibrillation (update) (CG180)

National Institute for Health and Care Excellence
New recommendations in this updated guideline include a personalised package of care and information, referral for specialised management, stroke prevention, rate and rhythm control and the management of acute atrial fibrillation.

 

Thrombolysis for Pulmonary Embolism and Risk of All-Cause Mortality, Major Bleeding, and Intracranial Hemorrhage: A Meta-analysis

Journal of the American Medical Association
Thrombolysis is associated with lower mortality (2.17% vs 3.89%; NNT 59) and recurrent PE (1.17% vs 3.04%; NNT 54) but higher risk of major bleeding (9.24% vs 3.42%; NNH 18) and intracranial haemorrhage (1.46% vs 0.19%; NNH 78), compared with anticoagulation in patients with PE.

 

Genotype-Guided vs Clinical Dosing of Warfarin and Its Analogues: Meta-analysis of Randomized Clinical Trials

JAMA Internal Medicine
This meta-analysis of 9 randomised studies (n=2,812) found that genotype-guided warfarin dosing was no better than clinical dosing protocols in terms of time within INR therapeutic range, number of patients with an INR>4, or incidence of major bleeding or thromboembolic events.

 

Vitamin K for improved anticoagulation control in patients receiving warfarin

Cochrane Database of Systematic Reviews
Two studies compared whether low dose (150 to 175 mcg) vitamin K given to patients with a high-variability response to warfarin improved INR control. One study showed significant improvement, while another smaller study suggested no overall benefit.

 

Phase III data for eltrombopag in paediatric patients with chronic immune thrombocytopenia

Biospace Inc.
In a Phase III study of paediatric patients with previously treated chronic immune (idiopathic) thrombocytopenic purpura (PETIT2; n=93), a consistent platelet response for 6 of 8 weeks was achieved in 39.7% of patients treated with eltrombopag (vs. 3.4% with placebo; p<0.001).

 

 

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