Saturday, 07 March 2015 13:13

Anticoagulation news items. Week commencing 2nd March 2015

Treatment for preventing bleeding in people with haemophilia or other congenital bleeding disorders undergoing surgery

Cochrane Database of Systematic Reviews

There is insufficient evidence from randomised controlled trials to assess the most effective and safe haemostatic treatment to prevent bleeding in people with haemophilia or other congenital bleeding disorders undergoing surgical procedures.

 

Diagnosis of atrial fibrillation after stroke and transient ischaemic attack: a systematic review and meta-analysis

The Lancet Neurology

By sequentially combining cardiac monitoring methods, AF might be newly detected in ~25% patients with CVA/TIA. Proportion with CVA known to have AF seems higher than previously estimated, so more could be treated with oral anticoagulants and more CVA recurrences prevented.

 

Vorapaxar approved for use in the EU for the reduction of atherothrombotic events in adults with a history of MI

European Medicines Agency

The European Medicines Agency has approved vorapaxar (Zontivity®) for use in combination with aspirin and, where appropriate, clopidogrel, for the reduction of atherothrombotic events in adult patients with a history of myocardial infarction.

 

Efficacy of Antiplatelet Therapy in Secondary Prevention Following Lacunar Stroke: Pooled Analysis of Randomized Trials

JAMA Stroke

Analysis of data from 17 trials (n=42,234, follow up 4 wks-3.5 yrs) found that use of any single antiplatelet agent was linked to significant reduction in recurrence of any stroke (risk ratio 0.77, 0.62–0.97, 2 trials) and ischaemic stroke (0.48, 0.30–0.78, 2 trials) vs. placebo.

 

Digoxin use in patients with AF and adverse cardiovascular outcomes: a retrospective analysis of the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in AF

The Lancet

In 14,171 patients, digoxin (DG) was used at baseline in 5239 (37%). DG was linked to significant increase in all-cause mortality, vascular death, and sudden death in patients with AF. A randomised trial of DG in treatment of AF patients with and without heart failure is needed.

 

NICE issues Final Appraisal Determination on apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism

National Institute for Health and Care Excellence

DRAFT guidance supports use of apixaban, within its marketing authorisation, as an option for treating and for preventing recurrent deep vein thrombosis and pulmonary embolism in adults. Anticipated publication date of guidance is June 2015.

 

 

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