...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Drug Class, Renal Elimination, and Outcomes of Direct Oral Anticoagulants in Asian Patients: A Meta-Analysis
【24h】

Drug Class, Renal Elimination, and Outcomes of Direct Oral Anticoagulants in Asian Patients: A Meta-Analysis

机译：亚洲患者患者的药物类，肾脏消除和直接口服抗凝剂的结果：荟萃分析

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background: Direct oral anticoagulants (DOACs) have a better risk benefit profile in Asian patients with atrial fibrillation (AF). Whether treatment effects could be modified by drug class and dependency on renal elimination of studied agents has not yet been explored. Methods: We searched PubMed, CENTRAL, and CINAHL databases through November 2016 for phase III randomized controlled trials comparing DOACs with warfarin in patients with AF. Efficacy and safety outcomes were pooled according to drug class and dependency on renal elimination of DOACs and were compared with the Mantel-Haenszel fixed-effects model. Effect differences were assessed with Bucher's indirect comparisons using common estimates, once heterogeneity was low, and with the Bayesian method. Results: Among 6496 Asian patients from 6 trials, both direct thrombin inhibitors and factor Xa inhibitors, compared with warfarin, were associated with lower risks of stroke or systemic embolism and major bleeding (risk ratio [95% confidence interval], 0.51 [0.33-0.78], 0.74 ([0.58-0.96], 0.60 [0.41-0.86], and 0.59 [0.47-0.76], respectively). There was no between-group difference in direct thrombin inhibitors and factor Xa inhibitors or in DOACs with renal elimination less than 50% and 50% or greater (all I-2 25% and interaction P .05). Indirect comparisons within strata of drug class and dependency on renal elimination showed no preferential effect of any given regimen over another. There was no difference in effects on ischemic and hemorrhagic stroke, intracranial hemorrhage, myocardial infarction, and all-cause mortality between DOACs stratified by pharmacologic characteristics. Conclusions: DOACs, as a therapeutic class, outperform warfarin in efficacy and safety in Asian patients with AF.
机译：背景：在亚洲心房颤动（AF）患者中，直接口服抗凝剂（DOAC）具有更好的风险效益。治疗效果是否可以通过药物种类和对研究药物肾脏清除的依赖性来改变，目前还没有研究。方法：我们在2016年11月的PubMed、CENTRAL和CINAHL数据库中搜索比较房颤患者DOACs和华法林的III期随机对照试验。根据药物类别和对DOACs肾清除的依赖性，汇总疗效和安全性结果，并与Mantel-Haenszel固定效应模型进行比较。当异质性较低时，使用Bucher的间接比较（使用共同估计）和贝叶斯方法评估效应差异。结果：在6项试验的6496名亚洲患者中，与华法林相比，直接凝血酶抑制剂和因子Xa抑制剂均与较低的卒中或全身性栓塞和大出血风险相关（风险比[95%可信区间]、0.51[0.33-0.78]、0.74（[0.58-0.96]、0.60[0.41-0.86]和0.59[0.47-0.76]）。直接凝血酶抑制剂和因子Xa抑制剂组间差异无显著性，肾脏清除率低于50%和50%或更高的DOAC组间差异无显著性（所有I-2均<25%，且相互作用P>0.05）。在药物类别和对肾脏清除依赖性的分层内进行的间接比较表明，任何一种给药方案都没有优于另一种方案的效果。按药理学特征分层的DOAC对缺血性和出血性卒中、颅内出血、心肌梗死和全因死亡率的影响没有差异。结论：作为一种治疗类别，DOAC在亚洲AF患者中的疗效和安全性均优于华法林。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号