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https://www.readbyqxmd.com/read/29791257/the-use-of-direct-oral-anticoagulants-in-the-treatment-of-acute-venous-thromboembolism-in-cancer-patients
#1
Hikmat Abdel-Razeq, Antoine Finianos, Ali T Taher
Introduction - After the CLOT study, LMWHs (low-molecular weight heparins) have gradually replaced warfarin as the treatment of choice for VTE (venous thromboembolism) in cancer patients. Randomized controlled studies comparing DOACs (direct oral anticoagulants) to LMWHs in cancer patients are still limited. However, new emerging data are supporting the use of DOACs in cancer-associated thrombosis. Areas Covered - This review will discuss the recent studies that addressed the utilization of such agents in the treatment of VTE in cancer patients...
May 23, 2018: Expert Review of Hematology
https://www.readbyqxmd.com/read/29790365/non-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation-patients-with-bioprosthetic-valves
#2
Jason G Andrade, Elena Meseguer, Romain Didier, Charles Dussault, Jeffrey I Weitz
The non-vitamin K antagonist oral anticoagulants (NOACs), which include dabigatran, apixaban, edoxaban and rivaroxaban, are preferred over vitamin K antagonists for stoke prevention in most patients with non-valvular atrial fibrillation. The NOACs are contraindicated in atrial fibrillation patients with rheumatic mitral stenosis or mechanical heart valves. There is evidence that bioprosthetic heart valves are less thrombogenic than mechanical heart valves, but it is unknown whether the risk of thromboembolism in atrial fibrillation patients with bioprosthetic valves differs from that in patients without such valves...
May 23, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29789046/management-of-venous-thromboembolism-in-the-elderly-a-review-of-the-non-vitamin-k-oral-anticoagulants
#3
Laressa Bethishou, Tania Gregorian, Kimberly Won, Kristina Lopez, Laura V Tsu
Objective To provide an up-to-date review of the available evidence regarding pharmacotherapeutic management of venous thromboembolic events in the geriatric population. Data Sources A PubMed search of articles published through August 2017 was performed using a combination of the following words: apixaban, betrixaban, dabigatran, edoxaban, enoxaparin, geriatric, heparin, idaricizumab, rivaroxaban, and venous thromboembolism. Study Selection/data Extraction Relevant original research, review articles, and guidelines were assessed for the management of elderly patients with venous thromboembolism (VTE)...
May 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29767545/pharmacogenetics-of-novel-oral-anticoagulants-a-review-of-identified-gene-variants-future-perspectives
#4
Adna Ašić, Damir Marjanović, Jure Mirat, Dragan Primorac
Novel oral anticoagulants (NOACs) are becoming a therapy of choice in everyday clinical practice after almost 50 years during which warfarin and related coumarin derivatives were used as the main anticoagulants. Advantages of NOACs over standard anticoagulants include their predictable pharmacodynamics and pharmacokinetics, stable plasma concentrations and less drug-drug and food-drug interactions. However, pharmacogenetics has its place in administration of NOACs, as considerable interindividual variations have been detected...
May 16, 2018: Personalized Medicine
https://www.readbyqxmd.com/read/29761426/predictors-of-self-reported-adherence-to-direct-oral-anticoagulation-in-a-population-of-elderly-men-and-women-with-non-valvular-atrial-fibrillation
#5
Andrea P Rossi, Roberto Facchinetti, Elena Ferrari, Nicole Nori, Selena Sant, Elena Masciocchi, Elena Zoico, Francesco Fantin, Gloria Mazzali, Mauro Zamboni
There is a general lack of studies evaluating medication adherence with self-report scales for elderly patients in treatment with direct oral anticoagulants (DOACs). The aim of the study was to assess the degree of adherence to DOAC therapy in a population of elderly outpatients aged 65 years or older affected by non-valvular atrial fibrillation (NVAF), using the 4-item Morisky Medication Adherence Scale, and to identify potential factors, including the geriatric multidimensional evaluation, which can affect adherence in the study population...
May 14, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29760204/model-based-meta-analysis-to-evaluate-optimal-doses-of-direct-oral-factor-xa-inhibitors-in-atrial-fibrillation-patients
#6
Hideki Yoshioka, Hiromi Sato, Hiroto Hatakeyama, Akihiro Hisaka
The noninferiority of direct oral factor Xa (FXa) inhibitors (rivaroxaban, apixaban, and edoxaban) in treatment of atrial fibrillation were demonstrated compared with warfarin by several large clinical trials; however, subsequent meta-analyses reported a higher risk of major bleeding with rivaroxaban than with the other FXa inhibitors. In the present study, we first estimated the changes of prothrombin time (PT) in 5 randomized trials based on reported population pharmacokinetic and pharmacodynamic models and then carried out a model-based meta-analysis to obtain models describing the relationship between PT changes and the event rates of ischemic stroke/systemic embolism (SE) and of major bleeding...
May 22, 2018: Blood Advances
https://www.readbyqxmd.com/read/29757786/management-of-venous-thromboembolism-with-non-vitamin-k-oral-anticoagulants-a-review-for-nurse-practitioners-and-pharmacists
#7
Michelle Schmerge, Sally Earl, Carol Kline
BACKGROUND AND PURPOSE: Venous thromboembolism (VTE), comprising deep-vein thrombosis and pulmonary embolism, is associated with significant morbidity and mortality. Non-vitamin K oral anticoagulants (NOACs), including apixaban, betrixaban, dabigatran, edoxaban, and rivaroxaban, are as effective and safe as vitamin K antagonists (VKAs) for primary prophylaxis, treatment, and/or secondary prevention of VTE and present significant advantages in convenience of use. This review provides guidance to nurse practitioners (NPs) and pharmacists on NOAC usage for the management of VTE and examines how traditional anticoagulation clinics can adapt to cater to patients on NOACs...
April 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29754512/-stroke-prevention-in-the-elderly-effectiveness-and-safety-of-edoxaban-in-elderly-patients-according-to-the-results-of-the-engage-af-study
#8
László Márk
Atrial fibrillation is the most common clinically relevant arrhythmia frequently causing systemic thromboembolic events. Traditionally vitamin K antagonists had been used for decades to prevent these events. The emerging of the new direct anticoagulants has revolutionized this treatment and a gradual growth and extensive spread of usage is expected. The latest one approved in Hungary, edoxaban, is a factor Xa inhibitor. Once-daily administration and favourable safety profile are major benefits of this drug...
May 2018: Orvosi Hetilap
https://www.readbyqxmd.com/read/29748353/gastrointestinal-bleeding-with-edoxaban-versus-warfarin-results-from-the-engage-af-timi-48-trial-effective-anticoagulation-with-factor-xa-next-generation-in-atrial-fibrillation-thrombolysis-in-myocardial-infarction
#9
James Aisenberg, Prapti Chatterjee-Murphy, Kathryn Friedman Flack, Jeffrey I Weitz, Christian T Ruff, Francesco Nordio, Michele F Mercuri, Youngsook Choi, Elliott M Antman, Eugene Braunwald, Robert P Giugliano
BACKGROUND: The ENGAGE AF-TIMI 48 trial (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis In Myocardial Infarction) compared higher-dose edoxaban regimen (HD-ER) and lower-dose edoxaban regimen with well-managed warfarin in 21 105 patients with atrial fibrillation. The risk factors and clinical impact of gastrointestinal bleeding (GIB) in this trial have not been described in detail. METHODS AND RESULTS: This analysis was undertaken to identify risk factors for major GIB (MGIB) and compare the severity and outcomes of GIB with edoxaban and warfarin...
May 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29740750/comparing-the-cost-effectiveness-of-non-vitamin-k-antagonist-oral-anticoagulants-with-well-managed-warfarin-for-stroke-prevention-in-atrial-fibrillation-patients-at-high-risk-of-bleeding
#10
Alexa R Hospodar, Kenneth J Smith, Yuting Zhang, Inmaculada Hernandez
BACKGROUND: Several studies have compared the cost effectiveness of non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin using results from clinical trials evaluating NOACs. However, the time in therapeutic range (TTR) of warfarin groups ranged across clinical trials, and all were below the therapeutic goal of 70%. We compared the cost effectiveness of edoxaban 60 mg, apixaban 5 mg, dabigatran 150 mg, dabigatran 110 mg, rivaroxaban 20 mg, and well-managed warfarin with a TTR of 70% in preventing stroke among patients with atrial fibrillation at high risk of bleeding...
May 9, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29738377/proton-pump-inhibition-in-patients-treated-with-novel-antithrombotic-drugs-should-we-worry-about-thrombosis
#11
Tomáš Bolek, Matej Samoš, Ingrid Škorňová, Frantisek Kovář, Peter Galajda, Ján Stasko, Peter Kubisz, Marián Mokáň
Proton pump inhibition (PPI) administrated together with antiplatelet and anticoagulant agents reduces the risk of gastrointestinal hemorrhage. Several novel antithrombotic agents have been recently introduced for acute coronary syndrome patients (prasugrel, ticagrelor), or for patients requiring long-term anticoagulation (dabigatran, rivaroxaban, apixaban, edoxaban, betrixaban). In fact, these agents might offer even stronger inhibition of platelets or coagulation compared with older agents; and therefore, the need for gastroprotection might be even stronger when these new agents are used for long-term antithrombotic therapy...
April 24, 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29735612/signal-detection-for-bleeding-associated-with-the-use-of-direct-oral-anticoagulants
#12
Kobi T Nathan, Kelly M Conn, Robbert P van Manen, Jack E Brown
PURPOSE: The potential link between serious or life-threatening bleeding and the use of direct oral anticoagulants (DOACs) was evaluated. METHODS: Qualitative and quantitative reviews of case reports of bleeding events involving dabigatran, rivaroxaban, apixaban, edoxaban, and warfarin through March 31, 2017, were performed. A disproportionality analysis was conducted for each DOAC using an empirical Bayesian approach based on the relative reporting rate. Subanalyses were performed to assess (1) bleeding events (including mortality and life-threatening events) associated with DOACs among all adverse-event reports and (2) warfarin-related bleeding events...
May 7, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29730743/the-clinical-impact-of-edoxaban-for-the-patients-with-postoperative-anemia-after-total-hip-arthroplasty
#13
Yasuhisa Izushi, Naofumi Shiota, Tomonori Tetsunaga, Kenichi Shimada, Takashi Egawa, Tsukasa Kiuchi, Toru Sato, Ritsugi Takuma, Yoichiro Takami
BACKGROUND: Postoperative anemia is a common complication after total hip arthroplasty (THA). However, the effect of edoxaban on postoperative anemia after THA remains unclear. Here, we retrospectively evaluated the clinical assessment of postoperative anemia and the associated changes of coagulation parameters in patients undergoing thromboprophylaxis with edoxaban compared with fondaparinux as a conventional anticoagulant thromboprophylactic agent after THA. METHODS: One hundred and forty-nine patients who underwent THA from July 2010 to June 2012 were divided into two groups, according to whether they were operated on before or after the approval of edoxaban: the fondaparinux group (Group F: 86 patients) and the edoxaban group (Group E: 63 patients)...
May 5, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29723935/a-systematic-review-and-bayesian-network-meta-analysis-of-risk-of-intracranial-hemorrhage-with-direct-oral-anticoagulants
#14
Zachary Wolfe, Safi U Khan, Fahad Nasir, Charumathi Raghu Subramanian, Bradley Lash
BACKGROUND: The comparative risk of intracranial hemorrhage (ICH) among direct oral anticoagulants (DOACs) (dabigatran, rivaroxaban, apixaban, and edoxaban) remains unclear. OBJECTIVE: To determine the difference in risk of ICH between DOACs. METHODS: 17 randomized controlled trials (RCTs) were selected using PubMed/MEDLINE, EMBASE, CENTRAL (Inception - 31 December 2017). Estimates were reported as odds ratio (OR) with 95% credible interval (CR...
May 3, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29723893/causes-of-death-in-patients-with-venous-thromboembolism-anticoagulated-with-direct-oral-anticoagulants-a-systematic-review-and-meta-analysis
#15
Antonio Gómez-Outes, Ana Isabel Terleira-Fernández, Ramón Lecumberri, Mª Luisa Suárez-Gea, Gonzalo Calvo-Rojas, Emilio Vargas-Castrillón
Death is more frequent than nonfatal recurrent venous thromboembolism (VTE) and major bleeding after acute VTE. The analysis of the causes of death is fundamental to explore new strategies to reduce mortality rates in these patients. The authors performed a meta-analysis to analyze mortality and independently adjudicated causes of death in anticoagulated patients due to VTE, and to evaluate potential differences between different anticoagulant schemes. They searched MEDLINE and CENTRAL, from January 1, 2000, to January 31, 2017, and performed additional searches in Web sites of regulatory agencies, clinical trial registers, and conference proceedings...
May 3, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29723874/peri-operative-adverse-outcomes-in-patients-with-atrial-fibrillation-taking-warfarin-or-edoxaban-analysis-of-the-engage-af-timi-48-trial
#16
James D Douketis, Sabina A Murphy, Elliott M Antman, Laura T Grip, Michele F Mercuri, Christian T Ruff, Jeffrey I Weitz, Eugene Braunwald, Robert P Giugliano
BACKGROUND:  Peri-operative management of anticoagulated patients with atrial fibrillation (AF) is challenging. To gain information on the peri-operative management of edoxaban, we compared outcomes in patients on warfarin or edoxaban enrolled in ENGAGE AF-TIMI 48 who underwent a surgery or invasive procedure. METHODS:  Data from patients undergoing their first surgery/procedure were analysed and results compared by anticoagulant (warfarin vs. higher- or lower-dose edoxaban regimen [HDER and LDER, respectively])...
May 3, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29719492/design-and-rationale-of-the-non-interventional-edoxaban-treatment-in-routine-clinical-practice-in-patients-with-venous-thromboembolism-in-europe-etna-vte-europe-study
#17
Alexander T Cohen, Cihan Ay, Philippe Hainaut, Hervé Décousus, Ulrich Hoffmann, Sean Gaine, Michiel Coppens, Pedro Marques da Silva, David Jimenez Castro, Beatrice Amann-Vesti, Bernd Brüggenjürgen, Pierre Levy, Julio Lopez Bastida, Eric Vicaut, Petra Laeis, Eva-Maria Fronk, Wolfgang Zierhut, Thomas Malzer, Peter Bramlage, Giancarlo Agnelli
Background: Venous thromboembolism (VTE, including deep vein thrombosis [DVT] and pulmonary embolism [PE]) has an annual incidence rate of 104-183 per 100,000 person-years. After a VTE episode, the two-year recurrence rate is about 17%. Consequently, effective and safe anticoagulation is paramount. Edoxaban is a direct oral anticoagulant (DOAC) approved VTE treatment. Current safety and efficacy data are derived from clinical trials, and information about treatment durations beyond 12 months are not available...
2018: Thrombosis Journal
https://www.readbyqxmd.com/read/29710221/what-surgeons-should-know-about-non-vitamin-k-oral-anticoagulants-a-review
#18
Atul Verma, Andrew C T Ha, James T Rutka, Subodh Verma
Importance: Non-vitamin K oral anticoagulants (NOACs) are increasingly prescribed for patients to treat or prevent arterial or venous thromboembolism. The following 4 NOAC agents are approved by the US Food and Drug Administration for clinical use: dabigatran etexilate, apixaban, edoxaban tosylate, and rivaroxaban. A good understanding of these agents' pharmacologic properties is important for surgeons given their marked differences compared with warfarin sodium. This review highlights key practical issues surrounding the use of NOACs in the perioperative setting...
April 18, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29707095/a-case-of-a-reversible-neurologic-adverse-reaction-to-apixaban-confirmed-by-re-challenge
#19
James A Josyln, Furqan H Khattak, Stephen A Geraci
Post-marketing reporting of adverse drug events is essential for new medications, as pre-FDA approval studies lack sufficient subject numbers to detect signals for rare events. Prescriptions for the novel oral anticoagulant factor Xa inhibitors (rivaroxaban, apixaban, edoxaban) have equaled or exceeded those for vitamin K antagonists in many clinical settings requiring chronic anticoagulation, and those of injectable heparins for deep vein thrombosis prophylaxis. We report the case of a 60-year-old woman followed for permanent atrial fibrillation who was prescribed apixaban...
June 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29704172/a-direct-oral-factor-xa-inhibitor-edoxaban-ameliorates-neointimal-hyperplasia-following-vascular-injury-and-thrombosis-in-apolipoprotein-e-deficient-mice
#20
Yoshiyuki Morishima, Yuko Honda
Vascular injury activates the coagulation cascade. Some studies report that coagulation factor Xa and thrombin are implicated in proliferation of vascular smooth muscle cells and neointimal hyperplasia after vascular injury. The aim of this study was to determine the effect of an oral direct factor Xa inhibitor, edoxaban, on neointimal hyperplasia following the carotid artery injury in apolipoprotein E (ApoE)-deficient mice. Vascular injury was induced by the application of 10% ferric chloride to the carotid artery for 3 min in ApoE-deficient mice...
April 27, 2018: Journal of Thrombosis and Thrombolysis
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