Sunday, 30 May 2021 19:24

Anticoagulation news items. Weeks commencing 24th May 2021

Andexanet Alfa or Prothrombin Complex Concentrate for Factor Xa Inhibitor Reversal in Acute Major Bleeding : A Systematic Review and Meta-Analysis

Critical Care Medicine
Review of 21 studies (n=1716) found haemostatic effectiveness of 71% & 76% for andexanet & prothrombin complex concentrate respectively at 24hrs. Mortality rate was 23.3% & 15.8%. Analysis for controlling confounders did not demonstrate significant differences between treatments.

 

Effectiveness and safety among direct oral anticoagulants in nonvalvular atrial fibrillation: A multi-database cohort study with meta-analysis

British Journal of Clinical Pharmacology
Review of cohort studies (total n=227,679) found apixaban had a lower rate of ischaemic stroke or thromboembolism (HR 0.85, 95%CI 0.74-0.99) and major bleeding (0.61, 0.53-0.70) vs rivaroxaban. There were no significant differences in risk between apixaban and dabigatran.

 

Which is the best model to assess risk for venous thromboembolism in hospitalised patients?

British Medical Journal
Practice article notes risk assessment models (RAMs) help clinicians decide who should be offered pharmacological thromboprophylaxis, but variation exists in their composition of risk factors and thresholds for high and low risk, and there is uncertainty over the most optimal RAM.

 

 

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