27 related results for DOACs


Things to consider when aiming to prevent stroke in a patient with AF

E-Learning
EPCCS 2017 Prof. David Fitzmaurice and dr. Geert-Jan Geersing consider the updates in the latest ESC Guidelines on atrial fibrillation that are most relevant to GPs, including which risk scores can help to optimally manage AF, and which drawbacks the scores have.

NOACs confer lower bleeding risk than VKA in low-risk AF patients

Literature 21-6-2017 • Lip GYH et al., JAMA Cardiol. 2017
In AF patients with a single non-gender-related stroke risk factor, the risk of any bleeding was lower for apixaban and dabigatran compared with warfarin, while no difference in stroke prevention was seen.

FORTA classifies all DOACs and warfarin as beneficial for older AF patients

Literature 17-5-2017 • Wehling M, et al, Drugs & Aging 2017
Based on FORTA classification, all DOACs and warfarin were classified as beneficial or very beneficial for older AF patients, while there was lack of evidence for other vitamin K antagonists.

Doubled risk of acute MI in real world AF patients receiving DOACs or aspirin vs. VKA

Literature 11-4-2017 • Stolk LM et al., Br J Clin P harmacol 2017
Analysis of new users of rivaroxaban or dabigatran, aspirin and VKAs in CPRD reveals a two-fold increased risk of AMI in current users of DOAC or aspirin, as compared with VKA.

Undercoagulation was common in AF patients who suffered from stroke and impacts outcome

Literature 5-4-2017 • Xian Y et L., JAMA. 2017
In a contemporary registry, 84% of patients with a history of AF received no or subtherapeutic anticoagulation, which affected severity of stroke and in-hospital mortality.

Gastrointestinal safety profiles differ among direct oral anticoagulants

Literature 28-3-2017 • Abraham NS, et al, Gastroenterology 2017
In a large population-based cohort of AF patients on DOACs, apixaban had most favourable gastrointestinal safety profile among all age groups, and rivaroxaban the least favourable. 

Reduced doses NOAC show similar efficacy and bleeding risk but possibly higher mortality risk

Literature 20-2-2017 • Nielsen PB et al., BMJ. 2017
Real-world data show lower dose NOACs associated with similar risk of thromboembolic events and similar or lower rates of bleeding as compared with warfarin in AF, but mortality risk seems higher with NOACs.

Lower risk of liver injury hospitalisation with DOACs as compared to warfarin

Literature 10-1-2017 • Alonso A et al., Heart. 2017
Dabigatran, rivaroxaban and apixaban users were less often associated with liver injury hospitalisation compared to warfarin and several variables could predict this.

Frequency of off-label dosing of NOACs and its consequences

Literature 22-12-2016 • Steinberg BA et al., JACC 2016
Many AF patients on NOAC therapy do not receive recommended doses for stroke prevention, and are at increased risk for CV hospitalisation and all-cause mortality.

DOACs also beneficial for elderly AF and VTE patients

Literature 11-10-2016 • Sadlon AH, Swiss Med Wkly, 2016
Rivaroxaban, apixaban, dabigatran and edoxaban were superior to VKAs in a meta-analysis of 8 studies comprising elderly patients with atrial fibrillation or venous thromboembolism.

Real-world safety data show differences between anticoagulants in AF patients

Literature 23-8-2016 • Lip GYH et al., Thromb Haemost 2016
In a real-world observational study using propensity score matched cohorts, apixaban initiation was associated with significantly lower risk of major bleeding compared to warfarin and rivaroxaban.

Many AF patients inappropriately on aspirin monotherapy rather than on anticoagulation

Literature 1-7-2016 • Hsu JH et al., J Am Coll Cardiol 2016
Approximately one third of AF outpatients at moderate to high risk for stroke treated by a cardiovascular specialist, received aspirin monotherapy, in spite of the lack of data supporting this practice.

Using 5 or more drugs concomitantly increases risk for comorbidity and complications in AF

Literature 29-6-2016 • Jaspers Focks J et al., BMJ 2016
In the ARISTOTLE trial population, polypharmacy was common and associated with higher comorbidity, mortality, and higher event rates of thromboembolic complications and major bleeding.

EHRA practical guide for non-vitamin K antagonist anticoagulants in non-valvular AF patients updated

News 15-6-2016
The European Heart Rhythm Association (EHRA) published a rewritten, updated version of the previously published (2013) guidelines for NOACs in non-valvular AF patients.

Direct oral anticoagulants result in lower risk of dementia in atrial fibrillation patients

Literature 9-6-2016 • Jacobs V, et al. Am J Cardiol. 2016
Treatment with direct oral anticoagulants was associated with a lower risk of cerebral ischemic events and new-onset dementia, in a retrospective analysis of 5,254 patients with atrial fibrillation.

Lower absolute number of bleeding events in the elderly with NOAC than with warfarin

Literature 1-6-2016 • Kato S et al., J Am Heart Assoc. 2016
In a pre-specified analysis from the ENGAGE AF-TIMI 48 trial, given the higher rates of bleeding in the elderly, a greater absolute reduction in safety events was seen with edoxaban as compared with warfarin than in younger patients.

Adherence to oral anticoagulation affects outcomes in AF patients at high stroke risk

Literature 29-2-2016 • Yao et al., J Am Heart Assoc. 2016
In patients with atrial fibrillation, adherence to oral anticoagulation for stroke prevention was modestly improved by the use of NOACs, which impacts mainly the outcomes of high-risk patients.

Next step on the way to approval of first antidote to anticoagulant effect of NOAC

News 28-9-2015
Following accelerated assessment, EMAs CHMP recommends granting a marketing authorisation for idarucizumab, a reversal agent for dabigatran, given its potential to respond to an unmet medical need.

Online Learning - EPCCS SPAF Consensus Document

News 6-8-2015
PeerVoice Education developed a learning activity about the EPCCS SPAF Consensus Document: "Expert Insights on EPCCS Recommendations for Stroke Prevention in Atrial Fibrillation: What General Practitioners Need to Know".

Anticoagulant edoxaban receives positive CHMP opinion for management of atrial fibrillation and venous thromboembolism

News 26-4-2015
CHMP recommends for direct inhibitor of factor Xa edoxaban to be granted marketing authorisation for prevention of stroke and systemic embolism in AF and the prevention and treatment of VTE.

Antidote for Factor Xa inhibitor shows positive results in phase III study

News 6-10-2014
The first Phase 3 study of Factor Xa inhibitor antidote andexanet alfa, met its primary and secondary endpoints and shows well-tolerated and effective reversal of anticoagulation activity of apixaban.

A more nuanced view from the clinic on the critical BMJ publications about dabigatran

News 19-8-2014
Dr. Michiel Coppens (vascular medicine, Academic Medical Center, Amsterdam, NL) shares his views on the critical publications in BMJ about the safety of using dabigatran.

BMJ criticises safety and use of dabigatran

News 18-8-2014
British Medical Journal writes that information has been withheld about the importance of monitoring plasma levels of dabigatran. We summarise the critic and the producer's response.

European approval of apixaban for treatment and prevention of recurrent DVT and PE

News 4-8-2014
The efficacy and safety of apixaban in the treatment of recurrent VTE/VTE-related death had been demonstrated in clinical trials AMPLIFY and AMPLIFY-NXT.

European approval for dabigatran for treatment of deep venous trombosis and pulmonary embolism

News 22-6-2014
The European Commission approved dabigatran etexilate for treatment of deep venous thrombosis and pulmonary embolism, and prevention of recurrent DVT and PE.

Rivaroxaban also effective at reducing stroke in AF patients over 75 years

Literature 16-6-2014 • Halperin JL et al., Circulation 2014
Factor Xa inhibition is as effective as adjusted-dose warfarin to anticoagulate patients of over 75 years old with nonvalvular AF, tor the prevention of stroke and systemic embolism.

In patients with acute VTE, NOACs are equally effective, but with a more favourable bleeding profile than VKA

Literature 9-3-2014 • Van der Hulle T et al. J Thromb Haemost. 2013
Meta-analysis shows that NOACs are as effective in the prevention of recurrent VTE, and give a lower risk of most types of bleedings, in patients with acute VTE.

Upcoming meetings

EPCCS Council Meeting December 6-7, 2017, Stratford Upon Avon, United Kingdom
10th EPCCS Annual CV Summit for Primary care March 15-16, 2018, Malaga, Spain
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Meeting reports & resources

EPCCS 2017 Report of the Cardiovascular Summit held in Dublin, Ireland
EPCCS Guidance Documents Evidence- and meeting-based guidance for primary care
EPCCS 2015 Report of 8th Annual EPCCS meeting held in Prague.
EPCCS 2014 Report of 7th Annual EPCCS meeting held in Brussels.
All meeting reports...