Friday, 25 March 2022 21:16

Anticoagulation news items. Weeks commencing 14th and 21st March 2022

Association of Type of Oral Anticoagulant Dispensed With Adverse Clinical Outcomes in Patients Extending Anticoagulation Therapy Beyond 90 Days After Hospitalization for Venous Thromboembolism

Journal of the American Medical Association
Cohort study (n=64,642) found a lower incidence of recurrent VTE for apixaban vs warfarin (9.8 vs 13.5/1000 person-years, HR 0.69, 95%CI 0.49-0.99), but no difference for apixaban vs rivaroxaban & rivaroxaban vs warfarin. Rates of major bleeding were similar for all treatments.

 

Physicians Adherence to Evidence-Based Guidelines as a Major Predictor to Anticoagulant-related Medication Errors Incidence and Severity

British Journal of Clinical Pharmacology
Study in tertiary hospital (n=116 with 2166 anticoagulant doses[ADs]) noted 44% prescribed ADs resulted in medication errors (MEs) & major predictor in increasing both MEs incidence & severity is physician adherence to evidence-based guidelines (OR 24.67; 95% CI 5.54–207;p<0.001).

 

Effect of Antiplatelet Therapy on Survival and Organ Support–Free Days in Critically Ill Patients With COVID-19: A Randomized Clinical Trial

Journal of the American Medical Association
RCT (n=1,557) found antiplatelet therapy (aspirin or P2Y12 inhibitor), vs no antiplatelet therapy, had a low likelihood of improving organ support–free days (composite of in-hospital mortality and duration of ICU–based respiratory or cardiovascular support) within 21 days.

 

How to handle a delayed or missed dose of edoxaban in patients with non-valvular atrial fibrillation? A model-informed remedial strategy

British Journal of Clinical Pharmacology
Simulation study exploring remedial strategies for edoxaban non-adherence recommends the missed dose can be taken immediately if the delay time is ≤11 h. A half dose followed by regular dosing is recommended for 12-19 h delay, and a full followed by half dose for a delay >19 h.

 

 

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