Document Detail


Long-term benefits of preventing venous thromboembolic events.
MedLine Citation:
PMID:  22533680     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Venous thromboembolism (VTE) and its long-term secondary complications are major health problems associated with high rates of morbidity and mortality and considerable costs for healthcare systems. Many patients receive suboptimal therapy, despite the availability of established and effective agents (including low molecular weight heparins, unfractionated heparin, fondaparinux and vitamin K antagonists) and evidence-based, internationally recognised guidelines. Limited knowledge of guidelines, concerns about bleeding risks and the inconvenience of parenteral administration and routine coagulation monitoring contribute to non-adherence to guidelines. Newer oral anticoagulants such as rivaroxaban, dabigatran etexilate, apixaban and edoxaban, which do not have the limitations of established anticoagulants, have been developed.
METHOD: Phase III randomised controlled trials for the treatment of acute VTE or for secondary prevention of recurrent VTE were identified in the PubMed and ClinicalTrials.gov databases. The search was limited to phase III studies and performed up to 26 March 2012 with the terms 'rivaroxaban OR Xarelto', 'dabigatran OR Pradaxa', 'apixaban OR Eliquis' and 'edoxaban OR DU-176b OR Lixiana'.
FINDINGS: A total of ten phase III studies, four published (three rivaroxaban, one dabigatran), three completed with results presented at recent congresses (dabigatran), and three ongoing (two apixaban, one edoxaban) were identified. Published and completed studies showed that rivaroxaban and dabigatran provided effective and convenient short-term treatment for deep vein thrombosis and VTE, respectively, when compared with standard of care, and showed superiority for long-term prevention of recurrent VTE when compared with placebo. Currently, rivaroxaban is the only newer anticoagulant that has been approved in Europe for the treatment of deep vein thrombosis and prevention of recurrent VTE.
CONCLUSIONS: Based on results of completed trials, rivaroxaban and dabigatran both may reduce the incidence of secondary complications of VTE and associated socioeconomic costs. Introduction of these newer anticoagulants is likely to have a substantial impact on clinical practice.
Authors:
Alexander T Cohen
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2012-05-24
Journal Detail:
Title:  Current medical research and opinion     Volume:  28     ISSN:  1473-4877     ISO Abbreviation:  Curr Med Res Opin     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-19     Completed Date:  2012-11-05     Revised Date:  2012-11-23    
Medline Journal Info:
Nlm Unique ID:  0351014     Medline TA:  Curr Med Res Opin     Country:  England    
Other Details:
Languages:  eng     Pagination:  877-89     Citation Subset:  IM    
Affiliation:
Surgery and Vascular Medicine, King’s College Hospital, London, UK. alexander.cohen@kcl.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / therapeutic use*
Benzimidazoles / therapeutic use
Clinical Trials, Phase III as Topic / statistics & numerical data
Follow-Up Studies
Humans
Morpholines / therapeutic use
Pyrazoles / therapeutic use
Pyridines / therapeutic use
Pyridones / therapeutic use
Randomized Controlled Trials as Topic / statistics & numerical data
Risk Assessment
Thiazoles / therapeutic use
Thiophenes / therapeutic use
Venous Thromboembolism / complications,  economics,  epidemiology,  prevention & control*
beta-Alanine / analogs & derivatives,  therapeutic use
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Benzimidazoles; 0/Morpholines; 0/Pyrazoles; 0/Pyridines; 0/Pyridones; 0/Thiazoles; 0/Thiophenes; 0/rivaroxaban; 107-95-9/beta-Alanine; 3Z9Y7UWC1J/apixaban; 480449-70-5/edoxaban; I0VM4M70GC/dabigatran
Comments/Corrections
Erratum In:
Curr Med Res Opin. 2012 Sep;28(9):1574
Note: Dosage error in article text

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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