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Total 23 results found since Jan 2013.

Oral anticoagulants: a systematic overview of reviews on efficacy and safety, genotyping, self-monitoring, and stakeholder experiences
ConclusionsFor stroke prevention in AF, direct OACs seem to be more effective and safer than usual care, and apixaban (5  mg twice daily) had the best profile. For VTE, there was no strong evidence that direct OACs were better than usual care. Education and pharmacist management could improve coagulation control. Both clinicians and patients rated efficacy and safety as the most important factors in managing AF and V TE.Systematic review registrationPROSPERO CRD42017084263 —one deviation; efficacy and safety were from one review.
Source: Systematic Reviews - October 28, 2022 Category: International Medicine & Public Health Source Type: research

Prospective randomised trial examining the impact of an educational intervention versus usual care on anticoagulation therapy control based on an SAMe-TT2R2 score-guided strategy in anticoagulant-naïve Thai patients with atrial fibrillation (TREATS-AF): a study protocol
Introduction The burden of atrial fibrillation (AF) in Thailand is high and associated with increased morbidity, mortality and healthcare costs. Vitamin K antagonists (eg, warfarin), commonly used for stroke prevention in patients with AF in Thailand, are effective but are often suboptimally controlled. We aim to evaluate the impact of an SAMe-TT2R2 score-guided strategy and educational intervention compared to usual care on anticoagulation control expressed by the time in therapeutic range (TTR) at 12 months, in anticoagulant-naïve Thai patients with AF. Methods and analysis Multicentre, open-label, parallel-grou...
Source: BMJ Open - October 11, 2021 Category: General Medicine Authors: Phrommintikul, A., Nathisuwan, S., Gunaparn, S., Krittayaphong, R., Wongcharoen, W., Sehmi, S., Mehta, S., Winkles, N., Brocklehurst, P., Mathers, J., Jowett, S., Jolly, K., Lane, D., Thomas, G. N., Lip, G. Y. H., TREATS-AF Study Group, Prasertwitayakij, Tags: Open access, Medical management Source Type: research

FDA Approves Expanded Peripheral Artery Disease (PAD) Indication for XARELTO ® (rivaroxaban) Plus Aspirin to Include Patients After Lower-Extremity Revascularization (LER) Due to Symptomatic PAD
RARITAN, N.J., August 24, 2021 – The Janssen Pharmaceutical Companies of Johnson & Johnson today announced that the U.S. Food and Drug Administration (FDA) has approved an expanded peripheral artery disease (PAD) indication for the XARELTO® (rivaroxaban) vascular dose (2.5 mg twice daily plus aspirin 100 mg once daily) to include patients following recent lower-extremity revascularization (LER) due to symptomatic PAD. The approval is based on data from the Phase 3 VOYAGER PAD study. With this approval, XARELTO® is the first and only therapy indicated to help reduce the risks of major cardiovascular (CV) events in p...
Source: Johnson and Johnson - August 24, 2021 Category: Pharmaceuticals Tags: Innovation Source Type: news

Practical challenges in the conduct of pragmatic trials embedded in health plans: Lessons of IMPACT-AFib, an FDA-Catalyst trial.
Abstract IMPACT-AFib was an 80,000-patient randomized clinical trial implemented by five US insurance companies (health plans) aimed at increasing the use of oral anticoagulants by individuals with atrial fibrillation who were at high risk of stroke and not on treatment. The underlying thesis was that patients could be change agents to initiate prescribing discussions with their providers. We tested the effect of mailing information to both patients and their providers. We used administrative medical claims and pharmacy dispensing data to identify eligible patients, to randomize them to an early or delayed interve...
Source: Clinical Trials - June 25, 2020 Category: Research Authors: Garcia CJ, Haynes K, Pokorney SD, Lin ND, McMahill-Walraven C, Nair V, Parlett L, Martin D, Al-Khalidi HR, McCall D, Granger CB, Platt R, Cocoros NM Tags: Clin Trials Source Type: research

Perceived Advantages and Disadvantages of Oral Anticoagulants, and the Trade-offs Patients Make in Choosing Anticoagulant Therapy and Adhering to Their Drug Regimen
Oral anticoagulant therapy (OAT) is proven to be highly effective for stroke prevention in patients suffering from atrial fibrillation (AF) [1,2]. Vitamin K antagonists (VKAs), particularly warfarin, which is the most commonly used VKA, have long been the standard of care to prevent AF-related stroke [3]. However, in recent years the European Medicines Agency has approved a number of direct oral anticoagulants (DOACs) as (possible) alternatives to VKAs. The perceived benefits of DOACs include their high efficacy and low risk of bleeding, the rapid onset/offset of action, fewer food and drug interactions, and predictable ph...
Source: Patient Education and Counseling - July 2, 2018 Category: International Medicine & Public Health Authors: Melissa C.W. Vaanholt, Marieke G.M. Weernink, Clemens von Birgelen, Catharina G.M. Groothuis-Oudshoorn, Maarten J. Ijzerman, Janine A. van Til Source Type: research

Factors associated with non –vitamin K antagonist oral anticoagulants for stroke prevention in patients with new-onset atrial fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice, up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists, and had higher socioeconomic status. Trial registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 25, 2017 Category: Cardiology Source Type: research

Safety of OnabotulinumtoxinA Treatment With Concomitant Antithrombotic Therapy in Patients With Post-stroke Spasticity: A Pooled Analysis of Randomized, Double-Blind Studies (S56.008)
Conclusions:There is no apparent increased risk of bleeding complications in patients on antithrombotics following IM onabotA treatment; nonetheless, careful observation of the injection site and patient education of the potential for bleeding complications remain warranted.Study Supported by: Allergan plc, Dublin, IrelandDisclosure: Dr. Dimitrova has received personal compensation for activities with Allergan as an employee. Dr. Dimitrova holds stock and/or stock options in Allergan. Dr. James has received personal compensation for activities with Allergan and Chase Pharmaceuticals as an employee. Dr. Liu has received per...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Dimitrova, R., James, L., Liu, C., Orejudos, A., Yushmanova, I., Brin, M. Tags: Movement Disorders: Huntington ' s Disease and Drug-Induced Dyskinesias Source Type: research

Factors Associated with Non-vitamin K Antagonist Oral Anticoagulants for Stroke Prevention in Patients with New-Onset Atrial Fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists and had higher socioeconomic status. Trial Registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 4, 2017 Category: Cardiology Source Type: research

Assessment of Web ‐based education resources informing patients about stroke prevention in atrial fibrillation
This study qualitatively assessed the information presented to patients in online resources about antithrombotic therapy for stroke prevention in AF.
Source: Journal of Clinical Pharmacy and Therapeutics - September 30, 2016 Category: Drugs & Pharmacology Authors: E. Pandya, B. V. Bajorek Tags: Original Article Source Type: research

The Educational Needs of Clinicians Regarding Anticoagulation Therapy for Prevention of Thromboembolism and Stroke in Patients With Atrial Fibrillation
The objective is to identify practice patterns and attitudes of and barriers faced by US physicians assessing thromboembolism/stroke risk and managing anticoagulation in atrial fibrillation (AF) to determine educational needs. Case-based surveys were used to assess practice patterns, guideline use, barriers, and attitudes; 51 cardiologists and 50 primary care physicians (PCPs) were surveyed. Most cardiologists use validated risk scoring systems to assess thromboembolism/stroke risk, and more than half of PCPs use clinical experience. Assessment of bleeding risk varied; more than half of respondents rely on clinical judgmen...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Glauser, T. A., Barnes, J., Nevins, H., Cerenzia, W. Tags: Articles Source Type: research

The Risk Stratification and Stroke Prevention Therapy Care Gap in Canadian Atrial Fibrillation Patients
Conclusions In a large Canadian AF population, primary care physicians did not provide a stroke or bleeding risk in a substantial proportion of their AF patients. When estimates were provided, they were on the basis of a predictive stroke and bleeding risk index in less than half of the patients. Furthermore, there was under- and overestimation of stroke and bleeding risk in a substantial proportion of patients. As many as 1 in 3 patients receiving warfarin have their TTR < 60%. These findings suggest an opportunity to enhance knowledge translation to primary care physicians.
Source: Canadian Journal of Cardiology - October 23, 2015 Category: Cardiology Source Type: research

How are patients with atrial fibrillation approached and informed about their risk profile and available therapies in Europe? Results of the European Heart Rhythm Association Survey
This European Heart Rhythm (EHRA) Scientific Initiatives Committee EP Wire Survey aimed at exploring the common practices in approaching patients with atrial fibrillation (AF) and informing them about their risk profiles and available therapies in Europe. In the majority of 53 responding centres, patients were seen by cardiologists (86.8%) or arrhythmologists (64.2%). First- and follow-up visits most commonly lasted 21–30 and 11–20 min (41.5 and 69.8% of centres, respectively). In most centres (80.2%) stroke and bleeding risk had the highest priority for discussion with AF patients; 50.9% of centres had a struc...
Source: Europace - February 26, 2015 Category: Cardiology Authors: Potpara, T. S., Pison, L., Larsen, T. B., Estner, H., Madrid, A., Blomstrom-Lundqvist, C., Conducted by the Scientific Initiatives Committee, and European Heart Rhythm Association, Conducted by the Scientific Initiatives Committee, and European Heart Rhyt Tags: EP WIRE Source Type: research

Reversing targeted oral anticoagulants.
Authors: Hoffman M, Monroe DM Abstract Dabigatran, rivaroxaban, and apixaban are orally active anticoagulants that are approved in many countries. Dabigatran inhibits thrombin, whereas rivaroxaban and apixaban are factor Xa inhibitors. In clinical trials, these novel oral anticoagulants were at least as effective as warfarin for preventing stroke in patients with atrial fibrillation, but with a lower rate of serious bleeding. However, the lack of true antidotes for these agents has caused concern when patients suffer life-threatening bleeding or trauma or require emergent invasive procedures. True antidotes are und...
Source: Hematology ASH Education Program - February 20, 2015 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Selection of Warfarin or One of the New Oral Antithrombotic Agents for Long-Term Prevention of Stroke among Persons with Atrial Fibrillation
Opinion statement Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder, which can potentially increases the risk of stroke by five-fold, thus, resulting in high public healthcare burden. Stroke prevention is vital in the management of AF patients. Vitamin K antagonists (VKA, eg, warfarin) have been the mainstay treatment to prevent ischemic stroke and systemic thromboembolism in AF patients for several decades. Despite the efficacy of warfarin, its limitations have recently driven the advent of some new antithrombotic agents, the non-VKA oral anticoagulant (NOACs, including dabigatran, ri...
Source: Current Treatment Options in Neurology - February 11, 2015 Category: Neurology Source Type: research

Research to real-world application: experts weigh in on the underuse of anticoagulants.
Abstract Although numerous studies have shown that anticoagulants can reduce the risk of stroke and thromboembolic events in patients with nonvalvular atrial fibrillation, they are underprescribed in the clinical setting. While standardized risk scoring assessments are recommended in treatment guidelines to determine when anticoagulant use may be appropriate, they are not widely used in the real-world clinical setting. Many factors contribute to anticoagulant underuse, including patient characteristics and comorbidities. Reluctance to prescribe an anticoagulant may also stem from concerns about bleeding or other p...
Source: The American Journal of Managed Care - December 1, 2014 Category: Health Management Authors: Berger J, Balfour Iii DC, Biskupiak JE, Dunn J, Liotta DB, Merli GJ, Pezalla EJ, Shaya FT, Villanueva T Tags: Am J Manag Care Source Type: research