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Thromb Haemostasis:VTE复发治疗和预防中采用利伐沙班与华法林的疗效和安全性比较?

2017-06-24 xing.T MedSci原创

在日常实践中,利伐沙班似乎可以减少了患者VTE复发和大出血的风险。这些结果与EINSTEIN研究以及上市后注册研究相一致。

利伐沙班与依诺肝素/维生素K拮抗剂在静脉血栓栓塞(VTE)复发的治疗和预防方面的疗效和安全性已经在EINSTEIN 随机试验中得到了证实。近日,血栓和凝血疾病权威杂志Thrombosis and Haemostasis上发表了一篇研究文章,研究人员旨在评估VTE患者的常规治疗中采用利伐沙班与华法林治疗的疗效和安全性。

研究人员采用美国2012年1月至2015年6月期间MarketScan的索赔数据进行分析,研究人员纳入了在住院/急诊初步诊断为深静脉血栓形成(DVT)或肺栓塞(PE)的成人,这些患者在VTE后30天内新启动利伐沙班或华法林治疗。在研究之初要求抗凝治疗的患者被排除在外。研究人员对VTE复发、大出血、颅内出血(ICH)和胃肠道出血(GIB)进行了评估。研究人员采用基于倾向得分的治疗权重负向概率来调整队列间基线特征的差异。

研究人员将患者进行了最长达VTE后12个月或直到终点发生、转换/停止抗凝或保险退保的随访。研究人员进行的Cox回归报道了风险比(HR)和95%可信区间(CI)。总的来说,共纳入了13609例采用利伐沙班治疗和32244例采用华法林治疗的VTE受试者。与华法林相比,利伐沙班与减少19 %(95 %CI为10-27 %)VTE复发以及21%(95 %CI为4-35 %)的大出血风险相关。利伐沙班还可以显著降低ICH(HR为0.40)和GIB(HR为0.72)的风险。

在日常实践中,利伐沙班似乎可以减少了患者VTE复发和大出血的风险。这些结果与EINSTEIN研究以及上市后注册研究相一致。

原始出处:

C. I. Coleman,et al. Effectiveness and safety of rivaroxaban versus warfarin for treatment and prevention of recurrence of venous thromboembolism.Thrombosis and Haemostasis.2017. https://doi.org/10.1160/TH17-03-0210

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    2017-07-11 changfy
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    2018-02-17 mhm289
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    2017-06-25 七九九八

    继续努力,加油加油

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2008271, encodeId=9bce20082e1b7, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Tue Jul 11 11:03:00 CST 2017, time=2017-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720814, encodeId=185f1e2081405, content=<a href='/topic/show?id=634ee040179' target=_blank style='color:#2F92EE;'>#疗效和安全性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70401, encryptionId=634ee040179, topicName=疗效和安全性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16ef32982072, createdName=经常头晕, createdTime=Sat Sep 30 22:03:00 CST 2017, time=2017-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1794293, encodeId=4edc1e94293a9, content=<a href='/topic/show?id=fb7d16e489b' target=_blank style='color:#2F92EE;'>#STAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16748, encryptionId=fb7d16e489b, topicName=STAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=af60254, createdName=mhm289, createdTime=Sat Feb 17 22:03:00 CST 2018, time=2018-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=215314, encodeId=b54d215314e4, content=继续努力,加油加油, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCcmyvDOwDu2ZpuYyovmsD12IBHmUCwr5bZqNic2p50ogCxUAIj4YqJ3PsGwoXOhJPQAvicmu6RqOww/0, createdBy=a0bf1958339, createdName=七九九八, createdTime=Sun Jun 25 17:59:17 CST 2017, time=2017-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214996, encodeId=f4d22149962e, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=d41c2055892, createdName=184****9840, createdTime=Sun Jun 25 01:10:02 CST 2017, time=2017-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214936, encodeId=73c621493629, content=在日常实践中,利伐沙班似乎可以减少了患者VTE复发和大出血的风险,进一步证实了利伐沙班的有效性与安全性,这是一项真实世界研究的结果,结论相对比较可信, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Sat Jun 24 22:41:22 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214881, encodeId=d48121488175, content=学习了。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=79351625688, createdName=1dd7a091m35(暂无匿称), createdTime=Sat Jun 24 18:01:04 CST 2017, time=2017-06-24, status=1, ipAttribution=)]
    2017-06-25 184****9840

    学习了谢谢分享

    0

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    2017-06-24 lovetcm

    在日常实践中,利伐沙班似乎可以减少了患者VTE复发和大出血的风险,进一步证实了利伐沙班的有效性与安全性,这是一项真实世界研究的结果,结论相对比较可信

    0

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    2017-06-24 1dd7a091m35(暂无匿称)

    学习了。。。。。

    0

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