Department of Clinical Pharmacology, Medical Faculty Mannheim, University of Heidelberg, Maybachstr. 14, 68169 Mannheim, Germany.
Hamostaseologie. 2013;33(1):62-70. doi: 10.5482/HAMO-12-11-0021. Epub 2013 Jan 24.
To compare the efficacy and safety of the new oral anticoagulants (NOAC), ideally head-to-head clinical trials should be performed. Given the expense of such an undertaking, it is highly unlikely that such a comparison would be performed. Therefore, there is a need for an unbiased comparative assessment of the benefits and risks of the NOACs, based on the available trial data. Indirect or mixed treatment comparisons may be an useful tool to overcome these limitations also known as network meta-analysis (NMA). The aim of this paper is to give an overview on published NMAs for dabigatran, rivaroxaban and apixaban, each assessed against warfarin in patients with atrial fibrillation, and against enoxaparin in patients undergoing total knee and total hip replacement surgery, in order to obtain insights into the comparability of the adopted methodological techniques.
为了比较新型口服抗凝药物（NOAC）的疗效和安全性，理想情况下应进行头对头的临床试验。鉴于进行此类研究的费用高昂，这种比较极不可能进行。因此，需要根据现有试验数据，对 NOAC 的获益和风险进行无偏倚的比较评估。间接或混合治疗比较可能是克服这些限制的有用工具，也称为网络荟萃分析（NMA）。本文的目的是概述已发表的关于达比加群、利伐沙班和阿哌沙班的 NMA，分别评估了房颤患者使用华法林、膝关节和髋关节置换手术患者使用依诺肝素的疗效，以便深入了解所采用的方法学技术的可比性。
