Horizon scanning: Phase II study of betrixaban vs. warfarin in patients with atrial fibrillation (Explore-Xa)

Source: Eur Heart J Area: News Betrixaban is an investigational once daily oral factor Xa inhibitor mostly excreted unchanged in the bile and with low (17%) renal excretion. The phase II study assessed its safety and tolerability at three different doses compared with warfarin in 508 patients with AF and more than one risk factor for stroke.   The patients had mean CHADS2 score of 2.2 and 87% had previously received vitamin K antagonist therapy. They were randomised to betrixaban 40, 60, or 80 mg once daily (n= 127 each dose) or unblinded warfarin, adjusted to an INR of 2.0-3.0 (n= 127). The primary outcome was major or clinically relevant non-major bleeding.   After a mean follow-up of 147 days:   . The time in therapeutic range on warfarin was 63.4%.   . There were 1, 5, 5, and 7 patients with a primary outcome on betrixaban 40, 60, 80 mg daily, or warfarin, respectively.   . The rate of the primary outcome was lowest on betrixaban 40 mg ...
Source: NeLM - Cardiovascular Medicine - Category: Cardiology Source Type: news

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Conclusion4FPCC appears to be an effective and safe option for FXaI-associated ICB with outcomes comparable to andexanet alfa. A formal prospective evaluation of this strategy versus andexanet alpha including cost analysis is warranted.
Source: Neurocritical Care - Category: Neurology Source Type: research
This post introduces a column I wrote over at TheHeart.org | Medscape Cardiology — The good news is that most people infected with coronavirus don’t need a hospital or doctor. But some do. Some get very ill. The maddening thing is that doctors don’t have an effective treatment for the virus. There are no cures. The Worldmeter today shows nearly 5 million infections and more than 300,000 deaths. And no effective therapy. Excluding a possibly modest effect of Remdesivir, our care is supportive, which is medical jargon for giving simple things like oxygen, acetaminophen, IV fluids and letting ...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs
Conclusion: In early-stage CKD, NOACs had a benefit-risk profile superior to that of VKAs. For advanced CKD or ESKD, there was insufficient evidence to establish benefits or harms of VKAs or NOACs. Primary Funding Source: None. (PROSPERO: CRD42017079709). PMID: 31307056 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
Remember Monty Python’s brilliant Life of Brian movie scene where the Palestinian insurgent commando, planning the abduction of Pilate’s wife in return for all the horrors they had to endure from the Roman Empire, asks the rhetorical question: what have the Romans ever done for us? With the hype and overmarketing, not to speak about the fears around A.I, we asked the same question. What has A.I. in medicine ever done for us? Well, we found at least 45 things. I have 45 responses to the pressing question on everyone’s mind who is interested in healthcare but tired of the hype or the doomsday scenarios a...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Artificial Intelligence in Medicine Future of Medicine administration AI cancer diagnostics digital health digital health technology Healthcare Innovation medical medical imaging Radiology treatment Source Type: blogs
Authors: Campbell BC Abstract In recent years, reperfusion therapies such as intravenous thrombolysis and endovascular thrombectomy for ischaemic stroke have dramatically reduced disability and revolutionised stroke management. Thrombolysis with alteplase is effective when administered to patients with potentially disabling stroke, who are not at high risk of bleeding, within 4.5 hours of the time the patient was last known to be well. Emerging evidence suggests that other thrombolytics such as tenecteplase may be even more effective. Treatment may be possible beyond 4.5 hours in patients selected using brain imagi...
Source: Medical Journal of Australia - Category: General Medicine Tags: Med J Aust Source Type: research
Emilio Rodríguez-Castro1,2, Manuel Rodríguez-Yáñez1,2, Susana Arias1,2, María Santamaría1,2, Iria López-Dequidt1,2, Ignacio López-Loureiro1, Manuel Rodríguez-Pérez1, Pablo Hervella1, Tomás Sobrino1, Francisco Campos1, José Castillo1* and Ramón Iglesias-Rey1* 1Clinical Neurosciences Research Laboratory, Department of Neurology, Clinical University Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain2Stroke Unit, Department of Neurology, Hospital Clínico Universitario, Santiago...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Johannes Schurig1,2*, Karl Georg Haeusler1,2,3, Ulrike Grittner4,5, Christian H. Nolte1,2, Jochen B. Fiebach1,2, Heinrich J. Audebert1,2, Matthias Endres1,2,5,6 and Andrea Rocco1,2 1Center for Stroke Research Berlin, Charité–Universitätsmedizin Berlin, Berlin, Germany 2Department of Neurology, Charité–Universitätsmedizin Berlin, Berlin, Germany 3Department of Neurology, Universitätsklinikum Würzburg, Würzburg, Germany 4Insitute of Biometry and Clinical Epidemiology, Charité – Universitätsmedizin Berlin, Berlin, Germany 5Berlin Institute of Heal...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
CONCLUSIONS: This study adds an attempt for treatment ranking of both efficacy and safety outcomes. Future trials comparing directly NOACs are needed in order to provide conclusive proofs for these results and not only circumstantial evidence offered by a network meta-analysis. PMID: 30896311 [PubMed - as supplied by publisher]
Source: Scandinavian Cardiovascular Journal - Category: Cardiology Tags: Scand Cardiovasc J Source Type: research
CONCLUSIONS: Longer mediastinal chest tube drainage after cardiac surgery is associated with a significantly lower incidence of late cardiac tamponade. PMID: 30835565 [PubMed - as supplied by publisher]
Source: Scandinavian Cardiovascular Journal - Category: Cardiology Tags: Scand Cardiovasc J Source Type: research
Conclusions: Our study is the largest study examining morbidly obese patients on DOACS and provides further evidence of comparable efficacy and safety of the direct oral anti-Xa inhibitors, compared to warfarin, in morbidly obese patients with AF and VTE.DisclosuresKushnir: Janssen: Research Funding. Billett: Bayer: Consultancy; Janssen: Research Funding.
Source: Blood - Category: Hematology Authors: Tags: 332. Antithrombotic Therapy: Management of Challenging Patients and Scenarios Source Type: research
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