European Medicines Agency
The CHMP considered that the main study did not satisfactorily show that its benefits outweighed its risk when used for preventing blood clots in patients admitted to hospital for recent medical illness. It was approved in the US in June 2017.
National Institute for Health and Care Excellence
This guideline aims to help healthcare professionals identify people most at risk and describes interventions that can be used to reduce the risk of venous thromboembolism (VTE).
Non-Vitamin K Antagonist Oral Anticoagulants and Risk of Serious Liver Injury
Journal of the American College of Cardiology
Analysis of Canadian administrative data (n=51,887) found current use of NOACs was not linked with increased risk of serious liver injury in patients without/with prior liver disease vs. use of vitamin K antagonists (HR:0.99;95% CI:0.68-1.45 and 0.68;0.33-1.37 respectively).
British Journal of Clinical Pharmacology
Taiwanese study (n= 57,058) reported that NSAID users had elevated risk of AF vs non‐users (adjusted OR=1.18, 95% CI: 1.14‐1.23). Users of non‐selective, and combined selective and non‐selective NSAIDs had elevated risk of AF (1.18; 1.13‐1.23 and 1.30; 1.21‐1.39, respectively).
Apixaban in patients at risk of stroke undergoing atrial fibrillation ablation
European Heart Journal
This RCT (n=633) reports primary outcome events (bleeding, stroke, or death) were observed in 6.9% of patients on apixaban, vs 7.3% of patients on vitamin K antagonists during ablation (difference −0.4%, non-inferiority P = 0.0002 based on definition used).
British Society for Haematology
The purpose of this guideline is to provide information and guidance on the management of venous thromboembolism (VTE) and bleeding complications of cancer and its treatment especially for children with leukaemia and other forms of cancer.
British Society for Haematology
This revised guideline discusses administration of fresh frozen plasma (FFP) primarily for 3 indications: prevention of bleeding, to stop bleeding (therapeutic) or for plasma exchange, suggesting many indications in patients without major bleeding are not substantiated.
European Heart Journal
This guide addresses management of non-vitamin K antagonist oral anticoagulants in various clinical situations eg how to deal with dosing errors, oral anticoagulant plasma level measurement (rare indications, precautions and potential pitfalls), management of bleeding etc.
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