Medicines Evidence Commentary : Bleeding risk with apixaban in people with renal impairment: meta-analysis of randomised controlled trials

National Institute for Health and Care Excellence

Discussion of a systematic review and meta-analysis published in 2014 in the American Journal of Cardiology which explored whether apixaban is superior to conventional agents with regard to bleeding complications in the subset of people with renal failure.

The association between kidney function and major bleeding in older adults with atrial fibrillation starting warfarin treatment: population based observational study

British Medical Journal

Among 12, 403 older Canadian adults with AF who started warfarin, rates of major bleeding were significantly higher in those with lower eGFR, particularly during the first 30 days of treatment. The NNH was 22 during the first 30 days vs 206 in the remainder of the follow-up.

Revised SPC: Revolade (eltrombopag)

electronic Medicines Compendium

Section 4.8 (undesirable effects) has been updated based on the latest pooled analysis of adverse events/ adverse drug reactions for ITP-controlled trials.

Outcomes in Mild Acute Ischemic Stroke Treated With Intravenous Thrombolysis: A Retrospective Analysis of the Get With the Guidelines–Stroke Registry

JAMA Neurology

This retrospective analysis found that use of thrombolysis after mild stroke (poorly represented in thrombolytic trials) was associated with infrequent complications; however 30% could not ambulate independently at discharge and 29.4% could not go directly home.

Revised SPC: Pradaxa tablets (dabigatran etexilate mesilate) – all strengths

electronic Medicines Compendium

Sections 4.8 and 5.1 have been updated to include new safety and efficacy data.

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