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https://www.readbyqxmd.com/read/28933799/rivaroxaban-for-preventing-venous-thromboembolism-in-high-risk-ambulatory-patients-with-cancer-rationale-and-design-of-the-cassini-trial-rationale-and-design-of-the-cassini-trial
#1
Alok Khorana, Saroj Vadhan-Raj, Nicole M Kuderer, Ted Wun, Howard Liebman, Gerald Soff, Chandra Belani, Eileen M O'Reilly, Robert McBane, John Eikelboom, C V Damaraju, Karen Beyers, Flavia Dietrich, Ajay Kakkar, Hanno Riess, Renata D'Alpino Peixoto, Gary H Lyman
Venous thromboembolism (VTE) is a frequent complication of cancer associated with morbidity, mortality, increased hospitalizations and higher health care costs. Cancer patients at increased risk for VTE can be identified using a validated risk assessment score, and the incidence of VTE can be reduced in high-risk settings using anticoagulation. Rivaroxaban is a potent, oral, direct, factor Xa inhibitor approved for the prevention and treatment of thromboembolic events, including VTE. CASSINI is a double-blind, randomized, parallel-group, multicentre study comparing rivaroxaban with placebo in adult ambulatory patients with various cancers who are initiating systemic cancer therapy and are at high risk of VTE (Khorana score ≥ 2)...
September 21, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28929298/chronic-kidney-disease-and-anticoagulation-from-vitamin-k-antagonists-and-heparins-to-direct-oral-anticoagulant-agents
#2
REVIEW
Savino Sciascia, Massimo Radin, Karen Schreiber, Roberta Fenoglio, Simone Baldovino, Dario Roccatello
Anticoagulation in patients with impaired kidney function can be challenging since drugs' pharmacokinetics and bioavailability are altered in this setting. Patients with chronic kidney disease (CKD) treated with conventional anticoagulant agents [vitamin K antagonist (VKA), low-molecular weight heparin (LMWH) or unfractionated heparin (UFH)] are at high risk of bleeding events (both non-major and major clinically relevant bleeding). While anticoagulation reduces the risk of thromboembolic events, the co-existing bleeding risk and the fact that the most commonly used anticoagulation agents are eliminated via the kidneys pose additional challenges...
September 19, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28926095/model-based-assessment-using-conventional-bioequivalence-limits-to-ensure-safety-and-efficacy-of-rivaroxaban-in-patients-undergoing-hip-or-knee-replacement
#3
Mario González-Sales, Lanyan Fang, Myong-Jin Kim, Liang Zhao
We evaluated whether the current bioequivalence limit is adequate to ensure safety and efficacy of rivaroxaban in patients under total hip arthroplasty and total knee arthroplasty based on its model informed benefit/risk profile. Clinical data from a total of 7145 patients from 3 phase 2 and 4 phase 3 clinical trials were included in the current model-based exposure-response analysis. The relationships between rivaroxaban exposure measurements (ie, minimum or trough, maximum, average concentration, and area under the concentration-time curve [AUC] at steady state) and clinical outcomes (ie, the probabilities of major bleeding [MB] and venous thromboembolism [VTE]) were modeled using NONMEM 7...
September 19, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28924530/dual-anticoagulation-in-recurrent-thromboembolic-events-with-failure-of-monotherapy-a-novel-approach
#4
Lakshmi Manogna Chintalacheruvu, Osman Bhatty, Venakata Giri Andukuri
In the last few decades many new anticoagulants (i.e direct thrombin and factor ten inhibitors) have been introduced with efficacy that rivals older drugs in the treatment of venous thromboembolism (VTE). However, for all their success, management of patients with recurrent thromboembolic events is still a challenging clinical scenario and not well addressed in the literature. We report the case of a young female with recurrent thromboembolisms in spite of using both newer agents and more conventional therapies...
July 7, 2017: Curēus
https://www.readbyqxmd.com/read/28921763/implementation-and-preliminary-clinical-outcomes-of-a-pharmacist-managed-venous-thromboembolism-clinic-for-patients-treated-with-rivaroxaban-post-emergency-department-discharge
#5
Baely M DiRenzo, Daren M Beam, Jeffrey A Kline, Karishma S Deodhar, Christina M Davis, Zachary A Weber, Todd A Walroth
OBJECTIVE: To describe the implementation, work flow, and differences in outcomes between a pharmacist-managed clinic for the outpatient treatment of venous thromboembolism (VTE) using rivaroxaban versus care by a primary care provider. INTERVENTIONS: Patients in the studied health system that are diagnosed with low-risk VTE in the emergency department are often discharged without hospital admission. These patients are treated with rivaroxban and follow up either in a pharmacist-managed VTE clinic or with their primary care provider...
September 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28920711/rivaroxaban-causes-missed-diagnosis-of-protein-s-deficiency-but-not-of-activated-protein-c-resistance-factor-v-leiden
#6
Elena Maryamchik, Matthew W Rosenbaum, Elizabeth M Van Cott
CONTEXT: - Rivaroxaban causes a false increase in activated protein C resistance (APCR) ratios and protein S activity. OBJECTIVE: - To investigate whether this increase masks a diagnosis of factor V Leiden (FVL) or protein S deficiency in a "real-world" population of patients undergoing rivaroxaban treatment and hypercoagulation testing. DESIGN: - During a 2.5-year period, we compared 4 groups of patients (n = 60): FVL heterozygous (FVL-HET)/taking rivaroxaban, wild-type/taking rivaroxaban, FVL-HET/no rivaroxaban, and normal APCR/no rivaroxaban...
September 18, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28919630/deep-vein-thrombosis-in-a-post-coronary-artery-bypass-grafting-patient-successful-conservative-management
#7
S H Sarker, A K Miraj, M A Hossain, M Aftabuddin
Deep vein thrombosis is an alarming medical emergency. Deep vein thrombosis or deep venous thrombosis (DVT) is the formation of a blood clot (thrombus) within a deep vein predominantly in the legs. Post-Coronary Artery Bypass Grafting deep vein thrombosis is a very rare medical condition relatively in Asian. Approximately 80% of deep vein thrombosis (DVTs) is clinically asymptomatic, 20% of those that actually demonstrate signs and symptoms can be easily confused with symptoms of other commonly presenting musculoskeletal disorders...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28905863/antithrombotic-therapy-compass-points-to-low-dose-rivaroxaban-and-aspirin-for-secondary-prevention
#8
Gregory B Lim
No abstract text is available yet for this article.
September 14, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28902808/-anticoagulant-therapy-of-venous-thromboembolic-complications-balancing-between-risks
#9
K V Lobastov, S V Sapelkin
This article is a review of the literature, related to the problem of recurrence of venous thromboembolic complications and the possibilities of their secondary prevention. The problems of determining the rational duration of anticoagulant therapy on the basis of an individual assessment of its benefit and risk are considered. The information on modern prognostic models allowing quantitative assessment of the probability of hemorrhagic and thrombotic events occurrence is presented (Vienna prediction model, DASH, HAS-BLED, stratification according to ACCP 2016)...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28895074/in-vitro-comparison-of-the-role-of-p-glycoprotein-and-breast-cancer-resistance-protein-on-direct-oral-anticoagulants-disposition
#10
Sophie Hodin, Thierry Basset, Elodie Jacqueroux, Olivier Delezay, Anthony Clotagatide, Nathalie Perek, Patrick Mismetti, Xavier Delavenne
BACKGROUND: Pharmacokinetics of direct oral anticoagulants (DOACs) are influenced by ATP-binding cassette (ABC) transporters such as P-glycoprotein (P-gp) and Breast Cancer Resistance Protein (BCRP). OBJECTIVES: To better understand the role of transporters in DOAC disposition, we evaluated and compared the permeabilities and transport properties of these drugs. METHODS: Bidirectional permeabilities of DOACs were investigated across Caco-2 cells monolayer...
September 11, 2017: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/28894315/rivaroxaban-induced-hypersensitivity-syndrome
#11
Charles-Olivier Chiasson, Arnaud Canneva, François-Olivier Roy, Maxime Doré
No abstract text is available yet for this article.
July 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28892657/evaluation-of-dabigatran-rivaroxaban-and-apixaban-target-specific-assays-in-a-multicenter-french-study
#12
Isabelle Gouin-Thibault, Geneviève Freyburger, Emmanuel de Maistre, Sophie Susen, Xavier Delavenne, Jean-Louis Golmard, Yves Gruel, Pierre Sié
Dabigatran etexilate, rivaroxaban and apixaban (DOACs) are widely used and measurement of their concentration is desirable in certain clinical situations. Target-specific assays are available but limited information exists on their performance especially in their ability to accurately measure low and high concentrations. AIMS: To define, in a multicenter study, the precision and accuracy of DOAC measurements in daily practice. METHODS: 15 plasma samples (kindly provided by Hyphen-Biomed) spiked with 5 blinded concentrations of dabigatran, rivaroxaban or apixaban (targeted 0-40-100-250-500ng/mL, actual concentrations measured by HPLC-MS/MS), were sent to 30 haemostasis laboratories...
September 4, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28892526/rivaroxaban-vs-warfarin-sodium-in-the-ultra-early-period-after-atrial-fibrillation-related-mild-ischemic-stroke-a-randomized-clinical-trial
#13
Keun-Sik Hong, Sun U Kwon, Sang Hun Lee, Ji Sung Lee, Yong-Jae Kim, Tae-Jin Song, Young Dae Kim, Man-Seok Park, Eung-Gyu Kim, Jae-Kwan Cha, Sang Min Sung, Byung-Woo Yoon, Oh Young Bang, Woo-Keun Seo, Yang-Ha Hwang, Seong Hwan Ahn, Dong-Wha Kang, Hyun Goo Kang, Kyung-Ho Yu
Importance: In atrial fibrillation (AF)-related acute ischemic stroke, the optimal oral anticoagulation strategy remains unclear. Objective: To test whether rivaroxaban or warfarin sodium is safer and more effective for preventing early recurrent stroke in patients with AF-related acute ischemic stroke. Design, Setting, and Participants: A randomized, multicenter, open-label, blinded end point evaluation, comparative phase 2 trial was conducted from April 28, 2014, to December 7, 2015, at 14 academic medical centers in South Korea among patients with mild AF-related stroke within the previous 5 days who were deemed suitable for early anticoagulation...
September 11, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28891412/a-novel-prothrombin-time-method-to-measure-all-non-vitamin-k-dependent-oral-anticoagulants-noacs
#14
Tomas L Lindahl, Kerstin Arbring, Maria Wallstedt, Mats Rånby
BACKGROUND: There is a clinical need for point-of-care (POC) methods for non-vitamin K-dependent oral anticoagulants (NOACs). We modified a routine POC procedure: Zafena's Simple Simon™ PT-INR, a room-temperature, wet-chemistry prothrombin time method of the Owren-type. METHODS: To either increase or decrease NOAC interference, two assay variants were devised by replacing the standard 10 µL end-to-end capillary used to add the citrated plasma sample to 200 µL of prothrombin time (PT) reagent by either a 20 µL or a 5 µL capillary...
September 11, 2017: Upsala Journal of Medical Sciences
https://www.readbyqxmd.com/read/28888219/factor-xa-inhibition-by-rivaroxaban-in-the-trough-steady-state-can-significantly-reduce-thrombin-generation
#15
Shigeo Horinaka, Rie Sugawara, Yutaka Yonezawa, Toshihiko Ishimitsu
AIMS: The aim of the present study was to demonstrate evidence of reduced thrombin generation at the trough plasma rivaroxaban concentration. METHODS: A single-centre, prospective, non-randomised, drug intervention, self-controlled study was conducted in 51 anticoagulation therapy-naïve patients with non-valvular atrial fibrillation. Plasma rivaroxaban concentration was measured by liquid chromatography tandem mass spectrometry (LC-MS/MS) and anti-factor Xa chromogenic assay...
September 9, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28887621/comparison-of-prescribing-practices-with-direct-acting-oral-anticoagulant-protocols
#16
Evan Draper, Brandon Parkhurst, Blake Carley, Kori Krueger, Tonja Larson, Sara Griesbach
BACKGROUND: The goal of anticoagulation management programs is to prevent thrombosis while minimizing the risks of hemorrhage. Direct acting oral anticoagulants (DOACs) selectively inhibit coagulation proteins to inhibit thrombosis. Previous studies suggest patient monitoring and education provided through anticoagulation services enhance adherence and decrease adverse outcomes in patients receiving DOAC therapy. OBJECTIVE: The objectives of this study were to describe DOAC prescribing adherence to anticoagulation service protocols and to observe whether enrollment in an anticoagulation service resulted in greater prescribing adherence to DOAC protocols...
September 8, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28886856/outcome-of-patients-receiving-thrombolytic-therapy-while-on-rivaroxaban-for-nonvalvular-atrial-fibrillation-from-rivaroxaban-once-daily-oral-direct-factor-xa-inhibition-compared-with-vitamin-k-antagonism-for-prevention-of-stroke-and-embolism-trial-in-atrial
#17
Sean T Chen, Anne S Hellkamp, Richard C Becker, Scott D Berkowitz, Günter Breithardt, Keith A A Fox, Werner Hacke, Jonathan L Halperin, Graeme J Hankey, Kenneth W Mahaffey, Christopher C Nessel, Jonathan P Piccini, Daniel E Singer, Manesh R Patel
The safety of intravenous thrombolysis in patients taking rivaroxaban has not been well established. We retrospectively analyzed the outcomes of all patients who received thrombolytic therapy in the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF). A review of medical and adverse event records for patients receiving thrombolytic therapy while enrolled in ROCKET AF was performed to determine their baseline characteristics, indications for thrombolysis, and type of agent used...
August 7, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28885651/the-practice-pattern-of-anticoagulation-prophylaxis-for-patients-undergoing-total-hip-replacement-in-a-major-orthopaedic-centre-a-retrospective-review
#18
Sura H Hamza, Paul Reynolds
METHODS: In a major centre for orthopaedic surgery, we retrospectively analysed 1,469 patients who underwent elective hip replacement since 2010. All patients but 2 received anticoagulation postoperatively and rivaroxaban was the preferred choice for anticoagulation. RESULTS: The incidence of all adverse events in those who received rivaroxaban was 1.7%. Only 0.3% had a minor upper gastrointestinal bleed and 1.3% developed a minor wound bleeding or haematoma. The occurrence of symptomatic venous thromboembolism (VTE) was 0...
September 5, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28882608/-intracranial-hemorrhage-and-oral-anticoagulants-of-patients-treated-between-2011-and-2013-at-the-nancy-regional-university-hospital
#19
A Leblanc, N Petitpain, O Pereira, H El Adssi, C Latarche, P Gillet, S Colnat-Coulbois
OBJECTIVE: To perform a descriptive analysis of intracranial hemorrhages of patients treated with an antivitamin K (fluindione, acenocoumarol or warfarin) or a direct oral anticoagulant (dabigatran, rivaroxaban or apixaban) at the Nancy Regional University Hospital. MATERIAL AND METHOD: The study period was from January 2011 to December 2013 and the computerized data (Programme de Médicalisation des Systèmes d'Information) of our hospital was accessed to identify the patients...
September 4, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28881533/-efficacy-and-safety-of-rivaroxaban-anticoagulant-therapy-in-the-treatment-of-atrial-fibrillation-cryoablation
#20
C Y Di, Z Wan, W H Lin
Objective: To observe the efficacy and safety of the novel oral anticoagulant Rivaroxaban for anticoagulation therapy in patients with nonvalvular atrial fibrillation (AF) during cryoablation. Methods: A total of 137 AF patients from October 2013 to December 2016 underwent cryoablation were divided into two groups according to the application of anticoagulant drugs: Rivaroxaban group (65 cases) and Heparin group (72 cases). Rivaroxaban group: oral administration of Rivaroxaban 20 mg, once a day, was started 3 days before the cryoablation, no anticoagulant was additionally added during cryoablation, the activated clotting time (ACT) was measured, and oral administration of Rivaroxaban was continued for 3 months after cryoablation...
September 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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