Friday, 08 April 2022 14:45

Anticoagulation news items. Week commencing 4th April 2022

Management of combined oral antithrombotic therapy by an Antithrombotic Stewardship Program: a prospective study

British Journal of Clinical Pharmacology
Study (n=460) found implementation of an antithrombotic stewardship program (ASP) improved use and safety of antithrombotic medication (ATM), with 54.6% of patients requiring ≥1 intervention from the ASP to optimise care (most commonly to define maximum duration of combined ATMs).

 

Risks of deep vein thrombosis, pulmonary embolism, and bleeding after covid-19: nationwide self-controlled cases series and matched cohort study

British Medical Journal
Study (n=1057174 matched to 4076342controls, Sweden) suggests covid-19 is risk factor for DVT,PE & bleeding with incidence rate ratios vs. control period significantly increased 70, 110 & 60 days after covid-19, respectively, particularly with more severe covid-19 & comorbidities.

 

Edoxaban versus Dual Antiplatelet Therapy for Leaflet Thrombosis and Cerebral Thromboembolism after TAVR: The ADAPT-TAVR Randomized Clinical Trial

Circulation
RCT (n=229) reports after transcatheter AVR, incidence of leaflet thrombosis was numerically but not statistically significantly lower with edoxaban vs dual antiplatelets (9.8% v 18.4%;p=0.076) & no difference in new cerebral thromboembolism & neurological/neurocognitive function.

 

Safety of the oral factor XIa inhibitor asundexian compared with apixaban in patients with atrial fibrillation (PACIFIC-AF): a multicentre, randomised, double-blind, double-dummy, dose-finding phase 2 study

The Lancet
RCT (n=753) found asundexian 20 and 50mg daily linked to lower observed rates of bleeding vs. apixaban (ratios of incidence proportions = 0.33;90% CI 0.09–0.97 for 20 & 50mg groups[2 events] v apixaban[6 events]), which was achieved despite near complete in-vivo FXIa inhibition.

 

 

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