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Specialty: Neurology
Drug: Pradaxa

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Total 127 results found since Jan 2013.

Evaluation of the Efficacy and Safety of Direct Oral Anticoagulants in Japanese Patients —Analysis of Pharmaceuticals and Medical Devices Agency Data
Two forms of direct oral anticoagulant (DOAC) have recently been introduced: direct thrombin inhibitors (DTI; e.g., dabigatran) and factor Xa inhibitors (FXa; e.g., rivaroxaban and apixaban). Despite the advantages of DOACs over warfarin with regard to cerebrovascular complications, those associated with DOACs have been reported with the increasing use of DOACs. Nevertheless, little is known about real-world comparative efficacy and safety of DOACs.
Source: Journal of Stroke and Cerebrovascular Diseases - February 3, 2017 Category: Neurology Authors: Yasuo Terayama Source Type: research

Anticoagulation Use and Clinical Outcomes After Major Bleeding on Dabigatran or Warfarin in Atrial Fibrillation Clinical Sciences
Conclusions—Dabigatran was associated with a superior benefit/risk ratio than warfarin and anticoagulation discontinuation in the treatment of atrial fibrillation patients who have survived a major bleed.
Source: Stroke - December 22, 2016 Category: Neurology Authors: Inmaculada Hernandez, Yuting Zhang, Maria M. Brooks, Paul K.L. Chin, Samir Saba Tags: Atrial Fibrillation, Quality and Outcomes, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

New frontiers in anticoagulation: non vitamin-K oral anticoagulants in stroke prevention.
Authors: Arnao V, Riolo M, Tuttolomondo A, Pinto A, Fierro B, Aridon P Abstract INTRODUCTION: Non vitamin-K oral anticoagulants (NOACs) are direct and specific inhibitors of the coagulation factors IIa (dabigatran) and Xa (apixaban, rivaroxaban, edoxaban) which share many pharmacokinetic properties. However, indications are lacking regarding the use of NOACs during thrombolysis, surgery and bleeding events. Areas covered: In this paper, the authors retrospectively analyzed the relevant literature on the NOACs using the PubMed and Google Scholar databases. Expert Commentary: Although warfarin is effective in cardioembo...
Source: Expert Review of Neurotherapeutics - December 3, 2016 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Idarucizumab as Antidote to Intracerebral Hemorrhage under Treatment with Dabigatran
Conclusions: In addition to clinical and preclinical studies, our cases add to the experience regarding the safety and efficacy of idarucizumab. They show that idarucizumab may be an important safety option for patients on dabigatran in emergency situations.Case Rep Neurol 2016;8:224 –228
Source: Case Reports in Neurology - October 31, 2016 Category: Neurology Source Type: research

Idarucizumab elimination of dabigatran minutes before systemic thrombolysis in acute ischemic stroke
We report the case of a 76-year-old woman, who received intravenous thrombolysis for acute treatment of an ischemic stroke immediately after elimination of dabigatran by intravenous application of the monoclonal antibody fragment, idarucizumab, which specifically reverses dabigatran anticoagulation. Currently, the RE-VERSE AD clinical trial is testing idarucizumab in two indications, uncontrolled bleeding and the need for urgent interventions or surgery.
Source: Journal of the Neurological Sciences - September 7, 2016 Category: Neurology Authors: Joachim G. Schulz, Bernard Kreps Tags: Letter to the Editor Source Type: research

Novel oral anticoagulants for the secondary prevention of cerebral ischemia: a network meta-analysis
Conclusions: The three NOACs showed differences in terms of safety and efficacy for secondary stroke prevention in NVAF. Our findings can serve only as hypothesis generation and require independent confirmation in head-to-head RCTs, owing to the sparse available evidence and increased uncertainty in both indirect effect estimates and ranking of treatments.
Source: Therapeutic Advances in Neurological Disorders - August 14, 2016 Category: Neurology Authors: Katsanos, A. H., Mavridis, D., Parissis, J., Deftereos, S., Frogoudaki, A., Vrettou, A.-R., Ikonomidis, I., Chondrogianni, M., Safouris, A., Filippatou, A., Voumvourakis, K., Triantafyllou, N., Ellul, J., Karapanayiotides, T., Giannopoulos, S., Alexandrov Tags: Original Research Source Type: research

Interactions between non-vitamin K oral anticoagulants and antiepileptic drugs
Atrial fibrillation (AF) is one of the most frequent causes of stroke. Secondary prophylaxis by oral anticoagulants (OACs) is recommended after stroke in patients with AF. For decades, vitamin-K antagonists (VKAs) were the only available drugs for OAC. In the last years, non-vitamin K antagonist oral anticoagulants (NOACs) like dabigatran, rivaroxaban, apixaban or edoxaban have been introduced as OAC drugs for patients with AF or venous thromboembolism, based on large randomized trials, and their use is recommended by various guidelines.
Source: Epilepsy Research - July 7, 2016 Category: Neurology Authors: Claudia St öllberger, Josef Finsterer Tags: Short communication Source Type: research

Intravenous Thrombolysis after Reversal of Dabigatran by Idarucizumab: A Case Report
We describe a 75-year-old female patient with nonvalvular atrial fibrillation who presented with acute ischemic stroke during treatment with dabigatran 2 × 110 mg per day. After informed consent, we reversed the anticoagulant effects of dabigatran using idarucizumab and applied an intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (off-label use). An intracerebral hemorrhage was excluded after systemic thrombolysis. Despite the IVT, the patient’s clinical condition deteriorated and she developed an ischemic lesion in the right pons, the right thalamus and right cerebellum. To date, the literatu...
Source: Case Reports in Neurology - June 27, 2016 Category: Neurology Source Type: research

Intravenous Thrombolysis With Recombinant Tissue-Type Plasminogen Activator in a Stroke Patient Receiving Dabigatran Anticoagulant After Antagonization With Idarucizumab Brief Reports
Conclusions— This case represents a new therapeutic paradigm. It is further supported by in vitro data showing no nonspecific interactions of idarucizumab with recombinant tissue-type plasminogen activator–induced thrombolysis. Thus, patients effectively anticoagulated with dabigatran who were previously contraindicated for thrombolytic therapy in this situation may now receive treatment because of the ability to rapidly reverse the anticoagulant activity of dabigatran with idarucizumab.
Source: Stroke - June 26, 2016 Category: Neurology Authors: Berrouschot, J., Stoll, A., Hogh, T., Eschenfelder, C. C. Tags: Cerebrovascular Procedures, Ischemic Stroke Brief Reports Source Type: research

Systemic Thrombolysis for Ischemic Stroke after Antagonizing Dabigatran with Idarucizumab —A Case Report
We here describe our experience of systemic thrombolysis therapy for severe ischemic stroke in a patient taking dabigatran for atrial fibrillation. After administration of the monoclonal antibody fragment idarucizumab, the anticoagulative effects of dabigatran were efficiently antagonized and application of alteplase was safe and feasible in our patient. This case report may illustrate a novel treatment option in the neurological emergency setting.
Source: Journal of Stroke and Cerebrovascular Diseases - May 24, 2016 Category: Neurology Authors: Niklas Sch äfer, Andreas Müller, Ullrich Wüllner Tags: Case Studies Source Type: research

Systemic Thrombolysis for Ischemic Stroke after Antagonizing Dabigatran with Idarucizumab—A Case Report
We here describe our experience of systemic thrombolysis therapy for severe ischemic stroke in a patient taking dabigatran for atrial fibrillation. After administration of the monoclonal antibody fragment idarucizumab, the anticoagulative effects of dabigatran were efficiently antagonized and application of alteplase was safe and feasible in our patient. This case report may illustrate a novel treatment option in the neurological emergency setting.
Source: Journal of Stroke and Cerebrovascular Diseases - May 24, 2016 Category: Neurology Authors: Niklas Schäfer, Andreas Müller, Ullrich Wüllner Tags: Case Studies Source Type: research

Systemic Thrombolysis for Ischemic Stroke after Antagonizing Dabigatran with Idarucizumab —A Case Report
We here describe our experience of systemic thrombolysis therapy for severe ischemic stroke in a patient taking dabigatran for atrial fibrillation. After administration of the monoclonal antibody fragment idarucizumab, the anticoagulative effects of dabigatran were efficiently antagonized and application of alteplase was safe and feasible in our patient. This case report may illustrate a novel treatment option in the neurological emergency setting.
Source: Journal of Stroke and Cerebrovascular Diseases - May 24, 2016 Category: Neurology Authors: Niklas Sch äfer, Andreas Müller, Ullrich Wüllner Tags: Case Studies Source Type: research

Cost-Effectiveness of Oral Anticoagulants for Ischemic Stroke Prophylaxis Among Nonvalvular Atrial Fibrillation Patients Clinical Sciences
Conclusions— All the newer oral anticoagulants compared were more effective than adjusted dosed warfarin. Our model showed that apixaban was the most effective anticoagulant in a general atrial fibrillation population and has an incremental cost-effectiveness ratio <$50 000/QALY. For those with higher stroke risk (CHADS2≥3), dabigatran was the most cost-effective treatment option.
Source: Stroke - May 22, 2016 Category: Neurology Authors: Shah, A., Shewale, A., Hayes, C. J., Martin, B. C. Tags: Anticoagulants, Cost-Effectiveness, Ischemic Stroke Clinical Sciences Source Type: research

Dabigatran etexilate reduces thrombin-induced inflammation and thrombus formation in experimental ischemic stroke.
Abstract Dabigatran etexilate (DE), a direct-acting, oral inhibitor of thrombin, significantly reduces the risk of stroke compared with traditional anticoagulants, without increasing the risk of major bleeding. However, studies on the fate of cerebral tissue after ischemic stroke in patients receiving DE are sparse and the role of dabigatran-mediated reduction of thrombin in this context has not yet been investigated. Here, we investigated whether pretreatment with DE reduces thrombin-mediated pro-inflammatory mechanisms and leakage of the blood-brain barrier (BBB) following ischemic stroke in rats. Male Wistar ra...
Source: Current Neurovascular Research - May 16, 2016 Category: Neurology Authors: Dittmeiera M, Wassmutha K, Schuhmanna MK, Krafta P, Kleinschnitz C, Fluri F Tags: Curr Neurovasc Res Source Type: research

From 'Sweet Clover Disease' to NOACs: A Historical Perspective on Oral Anticoagulation for Prevention of Cardioembolic Stroke (P2.397)
CONCLUSIONS: Warfarin, born from ‘sweet clover disease’ and humble beginnings as rodenticide, has been the cornerstone of cardioembolic stroke prevention. Its shortcomings inspired the development of a new generation of oral anticoagulants.Disclosure: Dr. Chiota-McCollum has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Chiota-McCollum, N. Tags: History of Neurology Source Type: research