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Primary Prevention of Ischaemic Stroke in Atrial Fibrillation: New Oral Anticoagulant Drugs for all?
Abstract Atrial fibrillation (AF) confers a 4.5% risk of stroke per year. The risk of stroke increases with various risk factors and until recently, warfarin has been the gold standard of thromboembolism prophylaxis in AF for many years. The dosage of warfarin requires regular adjustment dependent on the INR, to keep within a narrow therapeutic range of 2.0- 3.0. The INR can be altered by concomitant drugs, foods and alcohol and requires inconvenient blood monitoring. Underanticoagulation places patients at risk of stroke, whilst over-anticoagulation confers significant bleeding risk. Consequently approximately ha...
Source: Current Vascular Pharmacology - May 24, 2014 Category: Drugs & Pharmacology Authors: Foley J, Kirchhof P, Lip GY Tags: Curr Vasc Pharmacol Source Type: research

Risk factors for stroke and choice of oral anticoagulant in atrial fibrillation
ConclusionsThe uptake of DOACs was rapid and spurred an increase in new users of oral anticoagulants for atrial fibrillation from 2010 to 2015 in Norway. The mean CHA2DS2-VASc score did not change substantially during this period. Vascular disease, heart failure, and diabetes were associated with initiation of warfarin, and previous stroke, age 65 –74 and female sex with initiation of DOACs.
Source: European Journal of Clinical Pharmacology - August 16, 2018 Category: Drugs & Pharmacology Source Type: research

Selecting the right anticoagulant for stroke prevention in atrial fibrillation
CONCLUSIONS: Non-valvular AF patients on apixaban had lower rates of thromboembolic events than the patients on acenocumarol. This article will serve as a reminder of the positive health and financial outcomes of apixaban use, especially to those healthcare systems that are still oblivious to the decrease in economic burden and gain in quality-adjusted life years (QALY) by the long-term use of NOACS/ DOACS instead of the AVK anticoagulants.PMID:34286492 | DOI:10.26355/eurrev_202107_26241
Source: Pharmacological Reviews - July 21, 2021 Category: Drugs & Pharmacology Authors: N R Kundnani C I Rosca A Sharma A Tudor M S Rosca D D Nisulescu H S Branea V Mocanu D C Crisan D R Buzas S Morariu D F Lighezan Source Type: research

Testing the therapeutic equivalence of novel oral anticoagulants for thromboprophylaxis in orthopedic surgery and for prevention of stroke in atrial fibrillation.
CONCLUSIONS: Regardless of clinical implications, our results can be the basis to develop local acquisition tenderings on NOACS. In Italy, a new law has been issued according to which equivalence analyses have become a mandatory prerequisite for local tenderings. PMID: 25295718 [PubMed - in process]
Source: International Journal of Clinical Pharmacology and Therapeutics - June 4, 2015 Category: Drugs & Pharmacology Tags: Int J Clin Pharmacol Ther Source Type: research

Effectiveness and Safety of Non-Vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation and Venous Thromboembolism: A Systematic Review and Meta-Analyses.
Abstract PURPOSE: The findings from the observational studies comparing the effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) for atrial fibrillation (AF) and venous thromboembolism (VTE) are inconsistent. We conducted separate meta-analyses examining the efficacy/effectiveness and safety of NOACs versus VKAs by disease (AF vs VTE), study design (randomized controlled trials [RCTs] vs observational studies), and NOAC (dabigatran, rivaroxaban, apixaban, and edoxaban). METHODS: The main data sources included PubMed/MEDLINE, EMBASE, Web of Scienc...
Source: Clinical Therapeutics - June 28, 2017 Category: Drugs & Pharmacology Authors: Almutairi AR, Zhou L, Gellad WF, Lee JK, Slack MK, Martin JR, Lo-Ciganic WH Tags: Clin Ther Source Type: research

Efficacy and Safety of Direct Oral Anticoagulants vs Warfarin in Patients with Chronic Kidney Disease and Dialysis Patients: A Systematic Review and Meta-Analysis
ConclusionsIn pooled, analyzed randomized controlled trials and observational studies, DOACs were associated with better efficacy in early CKD, as well as similar efficacy and safety outcomes to warfarin in patients with CKD stages 4 –5 or dialysis patients. The results of patients with CKD stages 4–5 and dialysis patients were from observational studies. Well-designed randomized controlled trials focused on DOAC use in patients with CKD and dialysis patients are needed.PROSPERO register number: CRD42020150599, 6 February, 2020.
Source: Clinical Drug Investigation - March 11, 2021 Category: Drugs & Pharmacology Source Type: research

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