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https://www.readbyqxmd.com/read/28730690/incorporating-comprehensive-management-of-direct-oral-anticoagulants-into-anticoagulation-clinics
#1
Insaf Mohammad, Bianca Korkis, Candice L Garwood
Anticoagulation clinics emerged as a means to optimize warfarin effectiveness and minimize bleeding risks. Anticoagulation clinics have traditionally been warfarin-based models due to the need for frequent blood level monitoring, drug interactions, dietary considerations, and periprocedural management with warfarin. These models have demonstrated improved anticoagulation control and reduced bleeding complications for patients taking warfarin. Direct oral anticoagulants (DOACs) emerged with the perception of improved convenience due to the lack of blood level monitoring and lack of dietary considerations...
July 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28730619/real-world-adherence-and-persistence-with-direct-oral-anticoagulants-in-adults-with-atrial-fibrillation
#2
Beenish S Manzoor, Todd A Lee, Lisa K Sharp, Surrey M Walton, William L Galanter, Edith A Nutescu
BACKGROUND: Evidence of adherence and persistence patterns in anticoagulation (AC) therapy comparing treatment-naïve and non-naïve patients is lacking. The objective of this study was to evaluate patterns of medication adherence and persistence in a real-world setting among AC-naïve and AC-experienced atrial fibrillation (AF) patients treated with direct oral anticoagulants (DOACs). METHODS: AF patients newly initiating a DOAC with a minimum of 6 months of continuous health plan enrollment pre and post-index date (first DOAC prescription) were identified from the Truven Health MarketScan(®) Commercial and Medicare Supplemental databases (2009-2013)...
July 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28730526/direct-oral-anticoagulants-use-in-antiphospholipid-syndrome-are-these-drugs-an-effective-and-safe-alternative-to-warfarin-a-systematic-review-of-the-literature-comment
#3
REVIEW
Hannah Cohen, Beverley J Hunt, Maria Efthymiou, Ian J Mackie, Munther Khamashta, David A Isenberg
We respond to comments by Dufrost et al. about the RAPS trial, in particular, showing that the trial did achieve its target sample size; pointing out that thrombin potential is not synonymous with overall thrombin generation; confirming that overall, no increased thrombotic risk was evident comparing rivaroxaban with warfarin; and that high-risk patients (28% were triple positive, representative of patients with venous thromboembolism requiring standard-intensity anticoagulation) were included; and clarifying our rationale for using a laboratory surrogate primary outcome measure instead of a clinical one...
August 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28725494/apixaban-for-treatment-of-confirmed-heparin-induced-thrombocytopenia-a-case-report-and-review-of-literature
#4
Daniel E Ezekwudo, Rebecca Chacko, Bolanle Gbadamosi, Syeda Batool, Sussana Gaikazian, Theodore E Warkentin, Jo-Ann I Sheppard, Ishmael Jaiyesimi
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is a life and limb-threatening condition caused by the binding of platelet-activating antibodies (IgG) to multimolecular platelet factor 4 (PF4)/heparin complexes because of heparin exposure. The by-product of this interaction is thrombin formation which substantially increases the risk of venous and/or arterial thromboembolism. Currently, only one anticoagulant, argatroban, is United States Food and Drug Administration-approved for management of HIT; however, this agent is expensive and can only be given by intravenous infusion...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28725275/ash-meeting-2016-developments-in-hemostaseology
#5
REVIEW
Clemens Feistritzer, Birgit Mosheimer
During the annual meeting of the American Society of Hematology (ASH) in San Diego/California, novel developments in the field of hemostaseology were presented. Alternative treatment strategies besides factor replacement were discussed for patients with hemophilia. One of the highlights of the meeting in this year's plenary session was the presentation of successful adeno-associated virus mediated gene transfer in patients with hemophilia B leading to sustained elevation of factor IX:C (FIX:c). Other alternative treatment approaches in patients with hemophilia A may include bispecific antibodies mimicking factor VIIIa (FVIIIa) activity or disrupting anticoagulant proteins...
2017: Memo
https://www.readbyqxmd.com/read/28721332/to-stent-or-not-to-stent-a-tale-of-two-occlusions
#6
Ali S Haider, Lyndon K Lee, Tijani Osumah, Saira Alli, Umair Khan, Steven Vayalumkal, Aida Kafai Golahmadi, Richa Thakur, Phu Nguyen, Kennith F Layton
Stenting and balloon angioplasty, along with mechanical thrombectomy, have gained notability as adjunctive treatment options to intravenous tissue plasminogen activator (IV-tPA) for tandem internal carotid artery (ICA) and middle cerebral artery (MCA) occlusions (TIM occlusions). Acute ischemic strokes (AISs) secondary to TIM occlusions are associated with poor patient outcomes primarily due to low recanalization rates following intravenous thrombolysis, consequently prompting the need for more invasive recanalization efforts...
June 17, 2017: Curēus
https://www.readbyqxmd.com/read/28717737/rivaroxaban-an-affordable-and-effective-alternative-in-cancer-related-thrombosis
#7
Flávia Dias Xavier, Paulo Marcelo Gehm Hoff, Maria Ignez Braghiroli, Ana Carolina Carvalho Rocha Paterlini, Karla Teixeira Souza, Luiza Dib Batista Bugiato Faria, Fernando Sergio Blumm Ferreira, Karime Kalil Machado, Gustavo Dos Santos Fernandes
BACKGROUND: Venous thromboembolic events (VTEs) are common and potentially fatal complications in cancer patients, and they are responsible for the second most common cause of death. Low molecular weight heparin (LMWH) is the gold-standard treatment, but the costs involved limit its use, especially in developing countries. Recently, the oral anticoagulant rivaroxaban, which directly inhibits factor Xa, was approved for VTE treatment. METHODS: We conducted a retrospective analysis from January 2009 to February 2014 with patients who had cancer and VTE who were receiving rivaroxaban...
February 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28716241/low-risk-of-ich-after-reperfusion-therapy-in-acute-stroke-patients-treated-with-direct-oral-anti-coagulant
#8
Kentaro Suzuki, Junya Aoki, Yuki Sakamoto, Arata Abe, Satoshi Suda, Seiji Okubo, Takehiko Nagao, Kazumi Kimura
BACKGROUND: The safety of intravenous thrombolysis (IVT) and endovascular therapy (EVT) in patients treated with DOAC is unclear. We investigated whether recanalization therapy in patients treated with DOAC is safe. METHODS: A nationwide, multicenter, retrospective cohort questionnaire survey was conducted to investigate the: (1) frequency of intracerebral hemorrhage (ICH) after recanalization therapy in patients treated with DOAC; (2) independent factors related to ICH; (3) relationship between last intake time of DOAC and ICH; and (4) comparison of ICH frequency between patients treated with DOAC, vitamin K antagonist (VKA), and no-anticoagulation (no-ACT) (control)...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28713563/recent-advances-in-the-treatment-of-venous-thromboembolism-in-the-era-of-the-direct-oral-anticoagulants
#9
REVIEW
Jeffrey I Weitz, Iqbal H Jaffer, James C Fredenburgh
The direct oral anticoagulants (DOACs) have now supplanted vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE). The DOACs include dabigatran, which inhibits thrombin, and rivaroxaban, apixaban, and edoxaban, which inhibit factor Xa. The DOACs are as effective for the prevention of recurrence as conventional VTE treatment, consisting of a parenteral anticoagulant followed by a VKA, and are associated with less bleeding. Because of these properties and the convenience of fixed dosing without the need for routine coagulation monitoring, guidelines now recommend DOACs over VKAs for VTE treatment in patients without active cancer...
2017: F1000Research
https://www.readbyqxmd.com/read/28705401/-are-general-practitioners-in-paris-and-surrounding-areas-reticent-about-direct-oral-anticoagulants
#10
C Caucanas, D Sfeir, C Blas-Châtelain, P Priollet
OBJECTIVE: Determine how familiar general practitioners (GPs) working in Paris and surrounding areas are with prescriptions for direct oral anticoagulants (DOACs). MATERIAL AND METHOD: A questionnaire sent to 189 GP working in Paris and surrounding areas yielded 100 responses. Data collected included a brief summary of sociodemographic items, comparative knowledge about DOACs and vitamin K antagonists (VKAs), and responses to two clinical situations for DOAC prescriptions (renewal of a first prescription)...
May 2017: J Med Vasc
https://www.readbyqxmd.com/read/28705400/-have-general-practitioners-integrated-direct-oral-anticoagulants-in-their-practices
#11
EDITORIAL
P Frappé
No abstract text is available yet for this article.
May 2017: J Med Vasc
https://www.readbyqxmd.com/read/28704111/incomplete-dabigatran-reversal-with-idarucizumab
#12
Aaron P Steele, Jin A Lee, William E Dager
CONTEXT: With increasing use of direct oral anticoagulants (DOACs), urgent reversal of these agents becomes a growing concern. Idarucizumab is a humanized monoclonal antibody fragment that specifically binds to dabigatran with higher affinity than thrombin, rapidly neutralizing its anticoagulant effect without increased risk of thrombosis. CASE DETAILS: We describe two cases in which the recommended dose of idarucizumab was unsuccessful in completely reversing the anticoagulant effects of dabigatran...
July 13, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28703014/thrombin-receptor-agonist-peptide-induced-platelet-aggregation-is-reduced-in-patients-receiving-dabigatran
#13
Frantisek Nehaj, Juraj Sokol, Michal Mokan, Jela Ivankova, Maros Mokan
The availability of direct oral anticoagulants has caused a paradigm shift in thrombosis management. The direct thrombin inhibitor dabigatran seems to obstruct tenase complex by inhibiting thrombin generated in the initial phase and feed back to the amplification phase of cell-based coagulation reactions. However, it is still not fully understood if and how dabigatran impact platelet function. This observational study aimed to assess in vitro platelet function in patients with atrial fibrillation receiving dabigatran...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28701676/efficacy-and-safety-of-triple-therapy-and-dual-therapy-with-direct-oral-anticoagulants-compared-to-warfarin
#14
Hideo Amano, Daiga Saito, Takayuki Yabe, Ryo Okubo, Mikihito Toda, Takanori Ikeda
The efficacy and safety of direct oral anticoagulants (DOAC) with antiplatelet therapy compared to warfarin are unclear. The subjects were 280 patients who received antiplatelet therapy with oral anticoagulation (OAC) for the treatment of or protection from thromboembolism between January 2012 and September 2015. Among the 280 subjects, 79 (28.2%) received dual therapy (OAC plus aspirin or P2Y12 inhibitor) with DOAC, 75 (26.8%) dual therapy with warfarin, 46 (16.4%) triple therapy (OAC plus aspirin and P2Y12 inhibitor) with DOAC, and 80 (28...
July 13, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28700163/-direct-oral-anticoagulants-doac-practical-guidance-for-daily-prescription
#15
Helia Robert-Ebadi, Pierre Fontana, Françoise Boehlen, Marc Righini
The widespread introduction of direct oral anticoagulants (DOAC) represents a major step forward in the therapeutic management of patients with venous thromboembolic disease and atrial fibrillation, accompanied by new challenges. A thorough knowledge of the available evidence needs to be associated with pragmatism in order to address patients' individual issues. Access to documents containing practical guidance will certainly contribute to increase the efficacy and safety of prescription of these drugs for patients...
December 7, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28699943/dosing-accuracy-of-direct-oral-anticoagulants-in-an-academic-medical-center
#16
Janice Schwartz, Steve Merrill, Noelle de Leon, Ashley Thompson, Margaret Fang
BACKGROUND/OBJECTIVE: Direct-acting oral anticoagulants (DOACs) are increasingly used to prevent or treat thromboembolism. We conducted a study to compare how well initial DOAC prescribing for adult inpatients adhered to dosing recommendations approved by the US Food and Drug Administration (FDA). DESIGN: Retrospective analysis. SETTING: Single academic medical center, July 1, 2014 to June 30, 2015. PATIENTS: 508 adult inpatients...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28693744/changes-in-use-of-anticoagulation-in-patients-with-atrial-fibrillation-within-a-primary-care-network-associated-with-the-introduction-of-direct-oral-anticoagulants
#17
Jeffrey M Ashburner, Daniel E Singer, Steven A Lubitz, Leila H Borowsky, Steven J Atlas
Atrial fibrillation (AF) and the decision to anticoagulate is a common problem faced by primary care physicians. Oral anticoagulation (OAC) is underused, despite its clear benefits with regard to stroke prevention. We examined OAC usage between 2010 and 2015, following the introduction of direct oral anticoagulants (DOACs) and specifically assessed whether more patients were anticoagulated over time. The study cohort included adult patients aged 18 and older with AF cared for in an 18-practice primary care network between 2010 and 2015...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28689334/safety-and-interactions-of-direct-oral-anticoagulants-with-antiarrhythmic-drugs
#18
REVIEW
Ipek Celikyurt, Christoph R Meier, Michael Kühne, Beat Schaer
Direct oral anticoagulants (DOACs) are novel direct-acting medications that are selective for either thrombin or activated factor X. Due to their obvious benefits for patients (fewer interactions, broader therapeutic window, etc.), they are increasingly used as an alternative to warfarin, phenprocoumon, or acenocoumarol. One of the major indications for use of DOACs is stroke prevention in patients with atrial fibrillation (AF). However, interactions still exist, especially in combination with antiarrhythmic drugs (AADs), which are frequently given to AF patients for rhythm or rate control...
July 8, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28687549/implementation-of-a-direct-oral-anticoagulant-discharge-service
#19
Insaf Mohammad, Jesse Shuster, Elizabeth Petrovitch, Candice L Garwood
No abstract text is available yet for this article.
July 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28687262/renal-function-and-direct-oral-anticoagulant-treatment-for-venous-thromboembolism
#20
REVIEW
John Fanikos, Allison E Burnett, Charles E Mahan, Paul P Dobesh
As differences in renal function can affect the efficacy and safety of direct oral anticoagulants, prescribing an appropriate dose based on renal function is critical, especially in patient populations with a high incidence of renal impairment. In patients with nonvalvular atrial fibrillation and mild or moderate renal impairment, direct oral anticoagulants are associated with a better risk-benefit profile compared with warfarin. However, less is known regarding outcomes in patients with venous thromboembolism and renal impairment...
July 4, 2017: American Journal of Medicine
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