Items filtered by date: June 2018

Outcomes Associated with Apixaban Use in End-Stage Kidney Disease Patients with Atrial Fibrillation in the United States

Circulation

Retrospective cohort study (n=2351 on apixaban; 23,172 on warfarin) found apixaban use may be linked to lower risk of major bleeding vs. warfarin (HR 0.72, 95% CI 0.59-0.87; P<0.001) with standard 5mg BD dose also linked to reductions in thromboembolic and mortality risk.

 

 

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

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Antithrombotic Therapy for Peripheral Artery Disease in 2018

Journal of the American Medical Association

This article, form the US perspective, reviews current evidence and makes recommendations on antithrombotic therapy in patients with or without ischaemic limb symptoms, as well as in patients with or without manifest coronary or cerebrovascular disease.

 

Can small volume intramuscular injections be given to patients taking oral anticoagulants?

Specialist Pharmacy Service

Q+A notes most of published studies relate to IM influenza vaccination in patients on older anticoagulants. Data are limited and some findings are contradictory. There is very little published information about the risks of adverse effects with DOACs and IM injections.

 

Venous thromboembolism after induced abortion: a population-based, propensity-score-matched cohort study in Canada

The Lancet Haematology

Study (n= 176,001 matched to 880,005 non-pregnant) found 42-day risk of venous thromboembolism after induced abortion is double that of matched non-pregnant woman (30.1 v. 13.5/100,000; HR 2.23, 95% CI, 1.61–3.08), but is significantly lower than after livebirth (0.16; 0.12–0.22).

 

Roche introduces CoaguChek Vantus system with built in Bluetooth® technology in US

Biospace Inc.

Roche says this is first self-testing device for coagulation monitoring with built in Bluetooth technology. Patients can use tablet/smartphone with compatible app to send results via wireless connectivity, enabling healthcare providers to receive patients' INR results.

 

 

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

 

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Meta-Analysis of Studies Comparing Dual- Versus Mono-Antiplatelet Therapy Following Transcatheter Aortic Valve Implantation

American Journal of Cardiology

Analysis of 8 studies (n=2439) found dual antiplatelets (vs. mono) linked to increased risk at 30 days of all-cause mortality, major/life-threatening bleeding, and major vascular complications without decrease in ischaemic complications;at 6 months, excess bleeding risk persisted.

 

A clinical prediction model for cancer-associated venous thromboembolism: a development and validation study in two independent prospective cohorts

The Lancet Haematology

Data from CATS cohort (n=1423) were used to select prognostic variables for inclusion in clinical prediction model. Two in final model that were externally validated (tumour-site category/ D-dimer) predicted risk of venous thromboembolism in ambulatory patients with solid cancers.

 

Aspirin may be a follow-on option to prevent blood clots, starting five days after hip or knee surgery

National Institute for Health Research Signal

Expert commentary is provided for an RCT which found aspirin as effective as rivaroxaban at preventing VTE post hip or knee surgery. While there are implications for savings, the key message is that postoperative prophylaxis is the most important factor for attenuating VTE risk.

 

Gastrointestinal bleeding risk of selective serotonin reuptake inhibitors by level of kidney function: a population‐based cohort study

British Journal of Clinical Pharmacology

Cohort study (n=413,116) found an increasing adjusted rate difference of GI bleeding for SSRIs vs no SSRIs as kidney function deteriorated (2.0 events per 1000 person-years for no CKD vs 7.9 events per 1000 person-years for CKD stage 4/5, p-trend = 0.001).

 

Antithrombotic Therapy for Peripheral Artery Disease in 2018

Heart

This article reviews cardiovascular risk stratification of patients with peripheral artery disease and current standards of practice for use of antiplatelet and anticoagulant therapies.

 

Revised SPC: Eliquis (apixaban) 2.5 mg film-coated tablets

electronic Medicines compendium

The SPC has been amended to state that 'apixaban can be initiated or continued in NVAF patients who may require cardioversion', and to include detail on dose in relation to cardioversion. Data from the EMANATE study (conducted in patients undergoing cardioversion) has been added.

 

Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE): an international, randomised, placebo-controlled trial

The Lancet

In this study (n=1,754), the incidence of the primary composite endpoint was lower in those randomised to dabigatran 110mg BD (11% vs 15% with placebo; HR 0.72; 95% CI 0.55-0.93; p=0.0115), with no significant increase in major bleeding (3% v 4%; HR 0.92; 0.55-1.53; p=0.76).

 

 

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

Published in News