Saturday, 15 October 2016 09:39

Anticoagulation news items. Weeks commencing 10th October 2016

Ischaemic and haemorrhagic stroke associated with non-vitamin K antagonist oral anticoagulants and warfarin use in patients with atrial fibrillation: a nationwide cohort study

European Heart Journal

Analysis of registry data (2011–15) found that among 43, 299 anticoagulant-naïve AF patients, treatment with NOACs was not linked to significantly lower risk of stroke/thromboembolism vs. vitamin K antagonist but intracranial bleeding risk was lower with dabigatran and apixaban.

 

What factors should be considered when using LMWH to treat venous thromboembolism in patients with high body weight?

Specialist Pharmacy Service

This Q&A offers guidance on what factors should be considered when calculating a low molecular weight treatment dose following a venous thromboembolism in non-pregnant adult patients with a high body weight, defined as more than 120kg.

 

Safety and efficacy of minimally invasive surgery plus alteplase in intracerebral haemorrhage evacuation (MISTIE): a randomised, controlled, open-label, phase 2 trial

The Lancet Neurology

In this study of 96 patients, the primary outcomes (30 day mortality, 7 day procedure-related mortality, 72h symptomatic bleeding, and 30 day brain
infections) did not differ between the standard medical care vs minimally invasive surgery + alteplase groups.

 

FDA analyses conclude that results from ROCKET-AF trial of rivaroxaban were not affected by faulty INR meter

US Food and Drug Administration

In July 2016, Alere INRatio device, which was used to monitor warfarin in control group of trial was recalled due to potential to generate inaccurate results.
Following series of analyses, FDA has determined effects on strokes or bleeding, including cerebral bleeds were minimal.

 

Real-world comparison of major bleeding risk among non-valvular atrial fibrillation patients initiated on apixaban, dabigatran, rivaroxaban or warfarin. A propensity matched analysis

Thrombosis and Haemostasis

This study (n=45,361) found that apixaban and dabigatran were associated with a lower risk of major bleeding vs warfarin (HR 0.53, 95% CI 0.39-0.71 and 0.69, 0.50-0.96). Compared to apixaban, rivaroxaban was associated with higher risk of major bleeding (1.82, 1.36-2.43).

 

 

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