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Condition: Hemorrhagic Stroke
Drug: Pradaxa

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Total 307 results found since Jan 2013.

306 The Changing Face of Stroke in the DOAC Era
ConclusionThe majority of strokes occurring in anticoagulated patients are related to warfarin use. We observed an almost significant reduction in the proportion of ischaemic strokes due to under-dosing of OAC over the study period. Warfarin continues to be recommended as the first line anticoagulant for stroke prevention in atrial fibrillation by the HSE Medicines Management Programme, a decision which we would argue warrants review.
Source: Age and Ageing - September 16, 2019 Category: Geriatrics Source Type: research

Does X(a) mark the spot? An indirect mixed treatment comparison of Xa inhibitors compared to warfarin for patients with Atrial Fibrillation
ConclusionsThe Non-vitamin K antagonist oral anticoagulants constitute a new and promising category in the field of atrial fibrillation, even in the context of uncertainty, which an indirect comparison yields.
Source: Health Policy and Technology - August 10, 2019 Category: Health Management Source Type: research

Impact of methodological choices on a meta-analysis of real-world evidence comparing non-vitamin K antagonist oral anticoagulants with vitamin K antagonists for the treatment of patients with non-valvular atrial fibrillation.
Conclusions Sensitivity analyses showed the impact of similar assumptions was different depending on the outcome, and the drug considered. The development of recommendations and guidelines for the inclusion of RWE in meta-analyses could prove useful in evaluating the effectiveness of health care interventions. PMID: 31328580 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - July 24, 2019 Category: Research Tags: Curr Med Res Opin Source Type: research

Comparative Real-Life Effectiveness and Safety of Dabigatran or Rivaroxaban vs. Vitamin K Antagonists: A High-Dimensional Propensity Score Matched New Users Cohort Study in the French National Healthcare Data System SNDS
ConclusionConsistent with results from clinical trials and other observational studies, dabigatran and rivaroxaban were at least as effective and safer than VKAs for the prevention of thromboembolic events in NVAF over 1 year in the French population.Study registrationEuropean Medicines Agency EUPAS 13017 (www.encepp.eu) Clinicaltrials.gov id NCT02785354.
Source: American Journal of Cardiovascular Drugs - June 28, 2019 Category: Cardiology Source Type: research

Real-world 2-year outcome of atrial fibrillation treatment with dabigatran, apixaban, and rivaroxaban in patients with and without chronic kidney disease
AbstractPatients with non-valvular atrial fibrillation (NVAF) and chronic kidney disease (CKD) are at increased risk of stroke and bleeding. Although direct oral anticoagulant (DOAC) trials excluded patients with severe CKD, a growing portion of CKD patients have been starting DOACs and limited data from real-world outcome in this high-risk setting are available. The INSigHT registry included 632 consecutive NVAF patients that started apixaban (256 patients, 41%), dabigatran (245, 39%) and rivaroxaban (131, 20%) between 2012 and 2015. Based on creatinine clearance, two sub-cohorts were defined: (1) non-CKD group (CrCl 60 â...
Source: Internal and Emergency Medicine - May 8, 2019 Category: Emergency Medicine Source Type: research

Preventable Cases of Oral Anticoagulant-Induced Bleeding: Data From the Spontaneous Reporting System
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - April 29, 2019 Category: Drugs & Pharmacology Source Type: research

Direct oral anticoagulants in treatment of cerebral venous thrombosis: a systematic review protocol
DiscussionCurrent guidelines in the treatment of cerebral vein thrombosis dating back to 2011 from the American Heart Association/American Stroke Association endorse the utility of anticoagulation for the treatment of cerebral vein thrombosis; however, they did not support the use of direct oral anticoagulants. Updated guidelines from the European Stroke Organization, endorsed by the European Academy of Neurology in 2017, also refute utilization of direct oral anticoagulants due to a lack of evidence. There have been nearly 10  years of experience with direct oral anticoagulants in the treatment of venous thrombosis and ...
Source: Systematic Reviews - April 17, 2019 Category: International Medicine & Public Health Source Type: research

Number needed to treat based on real-world evidence for non-vitamin K antagonist oral anticoagulants versus vitamin K antagonist oral anticoagulants in stroke prevention in patients with non-valvular atrial fibrillation.
CONCLUSIONS: The NNT calculation, when approached and interpreted properly, is a practical measure of the effectiveness of a treatment. The calculation based on HRs showed that NOACs are safe and effective alternatives to VKAs in real life. PMID: 30969801 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - April 12, 2019 Category: Health Management Tags: J Med Econ Source Type: research

Advances in Antiplatelet and Anticoagulant Therapies for NSTE-ACS
AbstractThe treatment of patients requiring anticoagulation who develop acute coronary syndrome (ACS) and/or require percutaneous coronary intervention (PCI) must balance the reduction in major adverse cardiovascular events, stroke, and major bleeding. The development of direct oral anticoagulants (DOACs) for the treatment of atrial fibrillation has ushered in an era of potential treatment options for these complex patients.Purpose of ReviewTo review the clinical evidence underlying the use of DOACs for the treatment of patients with atrial fibrillation and ACS or PCI.Recent FindingsThree trials studied this particular pat...
Source: Current Cardiology Reports - January 12, 2019 Category: Cardiology Source Type: research

Treatment With Intravenous Alteplase for Acute Ischemic Stroke After Reversal of Dabigatran With Idarucizumab: A Case Study
Treatment options for anticoagulated patients presenting with ischemic stroke are limited. Off-label use of idarucizumab to rapidly reverse the anticoagulant effect of dabigatran may ensure eligibility for thrombolytic therapy with alteplase. This case describes a 77-year-old white male who presented to the hospital 89 minutes after sudden onset of right-sided hemiparesis, dysarthria, and facial palsy. Significant history included atrial fibrillation and previous right-sided cortical stroke. Medication reconciliation revealed he was taking dabigatran 150 mg twice a day, with the last dose being 179 minutes before presentat...
Source: Journal of Neuroscience Nursing - January 8, 2019 Category: Neuroscience Tags: Case Study Source Type: research

Oral Anticoagulation.
CONCLUSION: The evidence base for anticoagulation over a time frame of several years is inadequate at present, and direct comparative data for the different types of NOAC are not yet available. PMID: 30602410 [PubMed - in process]
Source: Deutsches Arzteblatt International - January 5, 2019 Category: General Medicine Tags: Dtsch Arztebl Int Source Type: research

Comparative effectiveness and safety of non-vitamin K antagonist oral anticoagulants versus warfarin in non-valvular atrial fibrillation patients: The dose subgroup analysis of the ARISTOPHANES study
ConclusionsIn this large observational study, api was the only NOAC associated with lower rates of S/SE and MB for both doses compared to warf. Dose selection criteria cannot be ascertained from current data sources. Future studies of pts who were appropriately dosed should be warranted.
Source: Archives of Cardiovascular Diseases Supplements - December 25, 2018 Category: Cardiology Source Type: research

Direct Oral Anticoagulants in Patients with Myeloproliferative Neoplasms: A Single Institution Retrospective Study
Discussion: Our limited data suggests that use of DOACs in patients with MPN is feasible with an acceptable balance between risk of hemorrhage and recurrent thrombosis. Additional data on long term outcomes of DOACs in MPNs are needed.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - November 21, 2018 Category: Hematology Authors: Deloughery, E. P., McBane, R. D., Ashrani, A. A., Tefferi, A., Slusser, J. P., Pruthi, R. K. Tags: 332. Antithrombotic Therapy Source Type: research

Analysis of the Safety Profile of Direct Oral Anticoagulants Using the FDA Adverse Event Reporting System
Conclusion:Our analysis found that among DOACs rates of breakthrough VTE were significantly higher with rivaroxaban, and that reported rates of ischemic stroke were significantly higher with dabigatran. While no DOACs have been compared against each other in prospective trials, post-marketing reports have suggested that different safety profiles exist among DOACs, a finding reiterated by our analysis. The significantly higher rate of VTE reported with rivaroxaban as compared to other DOACs has not previously been described to the best of our knowledge and deserves further analysis. The two methods of comparing the anticoag...
Source: Blood - November 21, 2018 Category: Hematology Authors: Deloughery, E. P., Shatzel, J. J. Tags: 332. Antithrombotic Therapy: Poster II Source Type: research

Dabigatran Versus Rivaroxaban for Secondary Stroke Prevention in Patients with Atrial Fibrillation Rehabilitated in Skilled Nursing Facilities
ConclusionsIn older adults treated with direct-acting oral anticoagulants after ischemic stroke, outcome rates varied considerably by drug and dosage.
Source: Drugs and Aging - November 13, 2018 Category: Geriatrics Source Type: research