Circulation
Review of the AUGUSTUS trial (n=4,456, reporting apixaban caused less bleeding and fewer hospitalisations than vitamin K antagonists in AF after ACS or PCI) found the safety and efficacy of apixaban was consistent irrespective of kidney function, as compared with warfarin.
Journal of the American Medical Association
RCT in 234 patients with acute ischaemic stroke found endovascular treatment (EVT) alone was noninferior to i/v alteplase plus EVT (functional independence at 90 days was achieved in 54.3% vs 46.6% respectively, a difference that met the prespecified noninferiority margin of 10%).
Journal of the American Medical Association
Trial in patients (n=204) with acute large vessel occlusion stroke failed to demonstrate non-inferiority (NI) of mechanical thrombectomy (MT) alone vs. combined i/v thrombolysis plus MT for favourable functional outcome (OR 1.09 [95% confidence limit below the NI margin of 0.74]).
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
Heart
In this Japanese retrospective cohort study (n=11,848), there were 0.57 cases of ischaemic stroke and systemic embolism per 100 person-years during mean of 3 yrs; 30% (95% CI 16.1-41.6%) of risk was attributable to modifiable risk factors (hypertension, diabetes, dyslipidaemia).
Positive Phase III results for valoctocogene roxaparvovec in the treatment of severe haemophilia A
Biospace Inc.
In the GENEr8-1 study (n=134), a single dose of valoctocogene roxaparvovec reduced annualised bleeding rate from a mean of 4.8 episodes per year at baseline to 0.8 per year, after a mean follow-up of 71.6 weeks (p<0.0001).
Revised SPC: Lixiana (edoxaban) Film-Coated Tablets – all strengths
electronic Medicines compendium
SPC advises that for patients unable to swallow, tablets may be crushed and mixed with water/apple puree and immediately administered. Alternatively, tablets may be crushed and suspended in water and immediately delivered through a gastric tube followed by flushing with water.
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
COVID-19, immunothrombosis and venous thromboembolism: biological mechanisms
Thorax
Review explores the pathobiological mechanisms of immunothrombosis and VTE in COVID-19 focusing on COVID-19-associated coagulopathy, pathology, endothelial dysfunction and haemostasis, the immune system and thrombosis, genetic associations and additional thrombotic mechanisms.
Medicines and Healthcare products Regulatory Agency
Data from observational studies suggest use of SSRI/SNRI antidepressants during month before delivery may result in small increased risk of postpartum haemorrhage. Prescribers should consider this risk vs. benefits of antidepressants for patient's mental health during this time.
National Institute for Health Research
RCT (n=1,858) found pharmaco-thromboprophylaxis alone was non-inferior to a combination of pharmaco-thromboprophylaxis and graduated compression stockings in terms of venous thromboembolism up to 90 days after surgery (1.7% vs 1.4%, p<0.001 for non-inferiority).
European Heart Journal
Article aims to provide an overview of the important milestones in antithrombotic pharmacology that have shaped clinical practice of today while also providing insights into knowledge gaps and future directions.
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