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Association between Use of Pharmacokinetic-Interacting Drugs and Effectiveness and Safety of Direct Acting Oral Anticoagulants: Nested Case-Control Study
Clin Pharmacol Ther. 2021 Jul 19. doi: 10.1002/cpt.2369. Online ahead of print.ABSTRACTConcomitant use of direct oral anticoagulants (DOACs) and medications with inhibition/induction effect on P-gp/CYP3A might increase risk of bleeding/treatment failure, respectively. We designed a nested case-control study within a Clalit cohort of atrial fibrillation (AF) patients and a cohort of venous thromboembolic patients, new users of a DOAC (1.1.2010-24.8.2020). Propensity scores were constructed from demographic, clinical and medications at cohort entry. Each case of: 1) serious bleeding event; 2) stroke/systemic emboli (SE) in A...
Source: Clinical Pharmacology and Therapeutics - July 21, 2021 Category: Drugs & Pharmacology Authors: Naomi Gronich Nilli Stein Mordehcai Muszkat Source Type: research

The real world use of combined P-glycoprotein and moderate CYP3A4 inhibitors with rivaroxaban or apixaban increases bleeding
AbstractThe use of direct oral anticoagulants for stroke prevention in atrial fibrillation continues to rise. Certain populations may be at higher risk for increased drug exposure and adverse events. Pharmacokinetic studies suggest increased exposure of rivaroxaban and apixaban with combined P-gp and moderate CYP3A4 inhibitors but the clinical relevance of this is unknown. This retrospective cohort study included patients receiving rivaroxaban or apixaban from January 1, 2012 to December 31, 2016 with a moderate inhibitor (amiodarone, dronedarone, diltiazem, verapamil) for at least 3 months in the drug –drug interaction ...
Source: Journal of Thrombosis and Thrombolysis - January 9, 2020 Category: Hematology Source Type: research

Patient outcomes using the European label for dabigatran. A post-hoc analysis from the RE-LY database.
In conclusion, this post-hoc simulation of dabigatran usage based on RE-LY trial dataset indicates that "EU label simulated dabigatran treatment" may be associated with superior efficacy and safety compared to warfarin, and are in support of the EU label and the 2012 European Society of Cardiology AF guideline recommendations. Thus, adherence to European label/guideline use results in a clinically relevant benefit for dabigatran over warfarin, for both efficacy and safety. PMID: 24326736 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - December 11, 2013 Category: Hematology Authors: Lip GY, Clemens A, Noack H, Ferreira J, Connolly SJ, Yusuf S Tags: Thromb Haemost Source Type: research

Low-dose intravenous heparin infusion in patients with aneurysmal subarachnoid hemorrhage: a preliminary assessment.
Conclusions In patients with Fisher Grade 3 aSAH whose aneurysm is secured, postprocedure use of a low-dose intravenous heparin infusion may be safe and beneficial. PMID: 24032706 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - September 13, 2013 Category: Neurosurgery Authors: Simard JM, Aldrich EF, Schreibman D, James RF, Polifka A, Beaty N Tags: J Neurosurg Source Type: research