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https://www.readbyqxmd.com/read/27886530/choosing-wisely-the-impact-of-patient-selection-on-efficacy-and-safety-outcomes-in-the-einstein-dvt-pe-and-amplify-trials
#1
Jan Beyer-Westendorf, Anthonie W A Lensing, Roopen Arya, Henri Bounameaux, Alexander T Cohen, Philip S Wells, Saskia Middeldorp, Peter Verhamme, Rodney Hughes, Nils Kucher, Akos F Pap, Mila Trajanovic, Martin H Prins, Paolo Prandoni, Jeffrey I Weitz
BACKGROUND: The results of the EINSTEIN-DVT/PE and AMPLIFY trials, which compared rivaroxaban and apixaban with conventional anticoagulation therapy for acute venous thromboembolism (VTE), respectively, are often compared. However, the trials differed in duration of therapy (3-12 and 6months, respectively) and in patient selection (few exclusion criteria and more stringent exclusion criteria, respectively). METHODS: To determine the effect of these methodological differences on outcomes, the patients enrolled in EINSTEIN-DVT/PE were divided into 2 cohorts; the 5253 patients that matched the exclusion criteria for AMPLIFY and were treated for at least 6months (cohort 1) and the 2368 patients who would have been ineligible for AMPLIFY (cohort 2)...
November 21, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27818480/rivaroxaban-for-periprocedural-anticoagulation-therapy-in-japanese-patients-undergoing-catheter-ablation-of-paroxysmal-non-valvular-atrial-fibrillation
#2
Mihoko Kawabata, Takeshi Sasaki, Shingo Maeda, Yasuhiro Shirai, Yasuteru Yamauchi, Junichi Nitta, Masahiko Goya, Kenzo Hirao
Direct oral anticoagulants (DOACs) have been shown to be safe and effective for the prevention of stroke in nonvalvular atrial fibrillation (NVAF) patients, however, experience with peri-AF ablation management of DOACs is scarce. This study aimed to investigate the safety and feasibility of periprocedural anticoagulation therapy with rivaroxaban in Japanese patients undergoing paroxysmal non-valvular AF (NVAF) ablation using radiofrequency energy.This study was a multicenter, prospective pilot study. In paroxysmal NVAF patients, rivaroxaban (15 mg or 10 mg once-daily) was started at least 4 weeks prior to AF ablation, discontinued on the day of the procedure, resumed within 24 hours after ablation, and continued at least 3 months afterwards...
November 4, 2016: International Heart Journal
https://www.readbyqxmd.com/read/27806307/rivaroxaban-versus-standard-anticoagulation-for-symptomatic-venous-thromboembolism-remotev-observational-study-analysis-of-6-month-outcomes
#3
Sébastien Gaertner, Elena-Mihaela Cordeanu, Salah Nouri, Alix-Marie Faller, Anne-Sophie Frantz, Corina Mirea, Pascal Bilbault, Patrick Ohlmann, Isabelle Le Ray, Dominique Stephan
BACKGROUND: This study aimed to provide safety and efficacy data of rivaroxaban in routine patient care in a non-selected symptomatic venous thromboembolism (VTE) population. METHODS AND RESULTS: REMOTEV is a prospective, non-interventional study of patients with acute symptomatic VTE, treated with oral rivaroxaban, VKA or parenteral heparin/fondaparinux alone for at least 3months and who are followed up for 6months. From Nov. 2013 to July 2015, 499 consecutive patients were retained for baseline analysis and 445 for safety analysis...
October 19, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27766043/doacs-advances-and-limitations-in-real-world
#4
Lai Heng Lee
The group of new oral anticoagulants or NOACs, now termed direct oral anticoagulants or DOACs, with their favourable results from large scale phase III clinical trials, represent a major advancement and expanded armamentarium in antithrombotic therapy. Dabigatran, rivaroxaban, apixaban and edoxaban are now in clinical routine use for prevention and treatment of arterial and venous thrombotic diseases as addressed in their clinical trials. Usage of the DOACs is expected to increase as clinicians gain more experience and reassurance with data from the real world studies which are generally consistent with that from clinical trials...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27696084/safe-and-effective-use-of-rivaroxaban-for-treatment-of-cancer-associated-venous-thromboembolic-disease-a-prospective-cohort-study
#5
Simon Mantha, Eva Laube, Yimei Miao, Debra M Sarasohn, Rekha Parameswaran, Samantha Stefanik, Gagandeep Brar, Patrick Samedy, Jonathan Wills, Stephen Harnicar, Gerald A Soff
Low-molecular weight heparin (LMWH) has been the standard of care for treatment of venous thromboembolism (VTE) in patients with cancer. Rivaroxaban was approved in 2012 for the treatment of pulmonary embolism (PE) and deep vein thrombosis (DVT), but no prior studies have been reported specifically evaluating the efficacy and safety of rivaroxaban for cancer-associated thrombosis (CAT). Under a Quality Assessment Initiative (QAI), we established a Clinical Pathway to guide rivaroxaban use for CAT and now report a validation analysis of our first 200 patients...
September 30, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27637548/laboratory-assessment-of-the-anticoagulant-activity-of-direct-oral-anticoagulants-doacs-a-systematic-review
#6
Bethany T Samuelson, Adam Cuker, Deborah M Siegal, Mark Crowther, David A Garcia
BACKGROUND: The direct oral anticoagulants (DOACs) are the treatment of choice for most patients with atrial fibrillation and/or non-cancer associated venous thromboembolic disease. While routine monitoring of these agents is not required, assessment of anticoagulant effect may be desirable in special situations. The objective of this study was to systematically review and summarize current evidence regarding laboratory assessment of the anticoagulant effects of dabigatran, rivaroxaban, apixaban and edoxaban...
September 13, 2016: Chest
https://www.readbyqxmd.com/read/27623682/spotlight-on-advances-in-vte-management-callisto-and-einstein-choice
#7
Miriam Bach, Rupert Bauersachs
Venous thromboembolism (VTE) is associated with numerous complications and high mortality rates. Patients with cancer are at high risk of developing cancer-associated thrombosis (CAT), and VTE recurrence is common. Evidence supporting use of non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) in patients with cancer is lacking - direct comparisons between NOACs and low-molecular-weight heparin (LMWH) are needed, along with patient-reported outcomes. Cancer Associated thrombosis - expLoring soLutions for patients through Treatment and Prevention with RivarOxaban (CALLISTO) is an international research programme exploring the potential of the direct, oral factor Xa inhibitor rivaroxaban for the prevention and treatment of CAT, supplementing existing data from EINSTEIN DVT and EINSTEIN PE...
September 28, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27592622/optimizing-the-safety-of-treatment-for-venous-thromboembolism-in-the-era-of-direct-oral-anticoagulants
#8
Jeffrey I Weitz, Iqbal H Jaffer
Direct oral anticoagulants (DOACs) are rapidly replacing vitamin K antagonists (VKAs) for treatment of venous thromboembolism (VTE). The DOACs include dabigatran, which inhibits thrombin, and rivaroxaban, apixaban, and edoxaban, which inhibit factor Xa. When compared with conventional VTE treatment consisting of a parenteral anticoagulant followed by a VKA, the DOACs were equally effective for prevention of recurrence, but were associated with less bleeding. With similar efficacy, better safety, 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...
September 5, 2016: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/27543162/venous-thromboembolism-treatment-outcomes-in-cancer-patients-and-effect-of-third-party-payers-on-anticoagulant-choice
#9
Gary W Jean, Katherine Kelly, Jennie Mathew, Eneko Larumbe, Randall Hughes
PURPOSE: The purpose of this study is to compare the rates of recurrent VTE among cancer patients treated with parenteral agents to the oral anticoagulants. METHODS: This single-center study was a retrospective chart review of cancer patients with recurrent VTE between January 1, 2009 and December 31, 2014. The primary outcome of the study is the rate of recurrent VTE in patients who received a parenteral anticoagulant (enoxaparin, dalteparin, fondaparinux) versus those who received oral anticoagulants (warfarin and rivaroxaban)...
January 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27346301/rivaroxaban-for-the-treatment-of-venous-thromboembolism-the-swiss-venous-thromboembolism-registry-swivter
#10
Nils Kucher, Drahomir Aujesky, Jürg H Beer, Lucia Mazzolai, Thomas Baldi, Martin Banyai, Daniel Hayoz, Thomas Kaeslin, Wolfgang Korte, Robert Escher, Marc Husmann, Beat Frauchiger, Iris Baumgartner, David Spirk
We investigated three-month clinical outcomes in patients with venous thromboembolism (VTE) treated with rivaroxaban or conventional anticoagulation in routine clinical practice. Between November 2012 and February 2015, 2,062 consecutive patients with VTE from 11 acute care hospitals in Switzerland were enrolled in the SWIss Venous ThromboEmbolism Registry (SWIVTER). Overall, 417 (20 %) patients were treated with rivaroxaban. In comparison to 1,645 patients on conventional anticoagulation, patients on rivaroxaban were younger (56 ± 18 vs...
August 30, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27161729/po-41-rivaroxaban-is-effective-therapy-for-high-risk-cancer-patients-with-venous-thromboembolic-disease
#11
P S Wells, I A Theberge, J C Bowdridge, M A Forgie, M Carrier
INTRODUCTION: The standard of care for cancer associated venous thromboembolism (VTE) is generally accepted to be at least six months of therapeutic doses of low molecular weight heparin (LMWH). After six months it is recommended that therapy be continued but no studies have evaluated treatment in this period. Rivaroxaban is a potentially effective therapy given cancer patients were enrolled in the EINSTEIN trial with acceptable safety and efficacy but details on these patients is lacking...
April 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27161723/po-36-thrombin-inhibition-preoperatively-tip-in-early-breast-cancer-the-first-clinical-trial-of-noacs-as-an-anti-cancer-agent-trial-methodology
#12
C C Kirwan, N J Bundred, J Castle, R Clarke, C Dive, J Morris, C Holcombe, J R Harvey
INTRODUCTION: Breast cancer is associated with a 3-4 fold increased risk of VTE. These patients have a 4-fold lower survival than those remaining free of VTE, implying VTE is a surrogate marker for aggressive cancer. Tumour expression of thrombin pathway markers are increased in the oestrogen receptor negative (ER-), high Ki67, more aggressive breast cancer subtypes. In in vitro and in vivo studies, the thrombin pathway promotes cancer growth and metastases, highlighting the potential role of the thrombin pathway as a therapeutic target in cancer...
April 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27161683/oc-11-anticoagulation-therapy-in-selected-cancer-patients-at-risk-of-recurrence-of-venous-thromboembolism
#13
A Young, J Phillips, H Hancocks, C Hill, N Joshi, A Marshall, J Grumett, J A Dunn, A Lokare, O Chapman
INTRODUCTION: Venous thromboembolism (VTE) in cancer patients is an increasingly frequent clinical problem. The overall impact of VTE on cancer patients can be considerable. Targeted patient selection by identifying patients with clinically significant recurrent VTE may have wider health economic benefits whilst reducing patient risk through over-treatment. In the UK, dalteparin is one licensed anticoagulant for the extended treatment and prevention of recurrence of VTE in cancer patients...
April 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27102510/treatment-of-venous-thromboembolism-with-new-anticoagulant-agents
#14
REVIEW
Cecilia Becattini, Giancarlo Agnelli
Venous thromboembolism (VTE) is a common disease associated with high risk for recurrences, death, and late sequelae, accounting for substantial health care costs. Anticoagulant agents are the mainstay of treatment for deep vein thrombosis and pulmonary embolism. The recent availability of oral anticoagulant agents that can be administered in fixed doses, without laboratory monitoring and dose adjustment, is a landmark change in the treatment of VTE. In Phase III trials, rivaroxaban, apixaban, edoxaban (antifactor Xa agents), and dabigatran (an antithrombin agent) were noninferior and probably safer than conventional anticoagulation therapy (low-molecular-weight heparin followed by vitamin K antagonists)...
April 26, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27030066/oral-rivaroxaban-versus-enoxaparin-with-vitamin-k-antagonist-for-the-treatment-of-symptomatic-venous-thromboembolism-in-patients-with-cancer-einstein-dvt-and-einstein-pe-a-pooled-subgroup-analysis-of-two-randomised-controlled-trials
#15
Martin H Prins, Anthonie W A Lensing, Tim A Brighton, Roger M Lyons, Jeffrey Rehm, Mila Trajanovic, Bruce L Davidson, Jan Beyer-Westendorf, Ákos F Pap, Scott D Berkowitz, Alexander T Cohen, Michael J Kovacs, Philip S Wells, Paolo Prandoni
BACKGROUND: Patients with venous thromboembolism and cancer have a substantial risk of recurrent venous thromboembolism and bleeding during anticoagulant therapy. Although monotherapy with low-molecular-weight heparin is recommended in these patients, in clinical practice many patients with venous thromboembolism and cancer do not receive this treatment. We aimed to assess the efficacy and safety of a single-drug regimen with oral rivaroxaban compared with enoxaparin followed by vitamin K antagonists, in the subgroup of patients with cancer enrolled in the EINSTEIN-DVT and EINSTEIN-PE randomised controlled trials...
October 2014: Lancet Haematology
https://www.readbyqxmd.com/read/27026636/recurrent-venous-thromboembolism-in-two-patients-with-cancer-taking-rivaroxaban
#16
Jacqueline M Theodorou, Yogini Patel, Patricia Ford
Pharmacologic agents for the treatment and prevention of venous thromboembolism in the cancer patient population are limited. Currently, low-molecular-weight heparin is recommended by national consensus guidelines for this indication. Rivaroxaban, an oral factor Xa inhibitor, is Food and Drug Administration (FDA) approved for the treatment and prevention of venous thromboembolism and offers the convenience of oral fixed-dose regimens, no routine laboratory monitoring, and has few drug and dietary interactions; however, its use in patients with cancer has not been largely studied...
March 29, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/26978472/-clinical-cases-of-effective-use-of-rivaroxaban-in-venous-thromboembolic-complications-management-in-patients-with-cancer-and-collagen-diseases
#17
https://www.readbyqxmd.com/read/26946695/-news-in-angiology-and-hemostasis
#18
Françoise Boehlen, Marc Blondon, Pierre Fontana
This update describes contemporary studies of clinical relevance in angiology and hemostasis. We discuss newer developments for the treatment of haemophilia, with a focus on drugs with longer-half lives. Direct anticoagulants (DOAC: rivaroxaban, apixaban, edoxaban and dabigatran) and their approved prescription in Switzerland are summarized, with a description of antidotes that will be available in the near future. We will present new data on the utility of cancer screening at the diagnosis of idiopathic venous thromboembolism (VTE) and on the evaluation of DOAC in patients with cancer-related VTE...
January 13, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/26867832/antithrombotic-therapy-for-vte-disease-chest-guideline-and-expert-panel-report
#19
Clive Kearon, Elie A Akl, Joseph Ornelas, Allen Blaivas, David Jimenez, Henri Bounameaux, Menno Huisman, Christopher S King, Timothy A Morris, Namita Sood, Scott M Stevens, Janine R E Vintch, Philip Wells, Scott C Woller, Lisa Moores
BACKGROUND: We update recommendations on 12 topics that were in the 9th edition of these guidelines, and address 3 new topics. METHODS: We generate strong (Grade 1) and weak (Grade 2) recommendations based on high- (Grade A), moderate- (Grade B), and low- (Grade C) quality evidence. RESULTS: For VTE and no cancer, as long-term anticoagulant therapy, we suggest dabigatran (Grade 2B), rivaroxaban (Grade 2B), apixaban (Grade 2B), or edoxaban (Grade 2B) over vitamin K antagonist (VKA) therapy, and suggest VKA therapy over low-molecular-weight heparin (LMWH; Grade 2C)...
February 2016: Chest
https://www.readbyqxmd.com/read/26797081/efficacy-and-safety-of-rivaroxaban-in-patients-with-venous-thromboembolism-and-active-malignancy-a-single-center-registry
#20
Dalene M Bott-Kitslaar, Rayya A Saadiq, Robert D McBane, Charles L Loprinzi, Aneel A Ashrani, Teresa R Ransone, Alissa A Wolfgram, Michelle M Berentsen, Waldemar E Wysokinski
OBJECTIVE: The purpose of this study is to evaluate the efficacy and safety of rivaroxaban in patients with venous thromboembolism and active malignancy, given the paucity of clinical data with the use of direct Xa inhibitors in this high-risk population. PATIENTS AND METHODS: Consecutive patients treated with rivaroxaban for deep vein thrombosis or pulmonary embolism, enrolled into Mayo Thrombophilia Clinic Direct Oral Anticoagulants Registry between March 1, 2013, and April 30, 2015, were followed prospectively to evaluate the efficacy and safety of this therapy...
June 2016: American Journal of Medicine
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