Hurst Katherine Victoria, O'Callaghan John Matthew, Handa Ashok
Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Vasc Health Risk Manag. 2017 Jul 10;13:263-267. doi: 10.2147/VHRM.S121944. eCollection 2017.
Direct oral anticoagulants (DOACs) are being increasingly used in the clinical setting for patients at risk of venous thromboembolism (VTE) and/or stroke. These medications offer valued benefits for long-term use, including a fast onset of anticoagulation, fixed anticoagulation profile (and consequent prescription of specified doses) and no requirement for routine monitoring. Apixaban is a selective factor Xa inhibitor, approved for use in the prevention of stroke in patients with nonvalvular atrial fibrillation and in the prevention and treatment of acute VTE. Like many of the DOACs, it has a fast onset of action and works to deliver predictable coagulation results. Multiple randomized controlled trials including ARISTOTLE and AMPLIFY have shown apixaban to be noninferior to vitamin K antagonists in the prevention of stroke and VTE, with a good safety profile. This article aims to review the use of apixaban for the prevention and treatment of thromboembolic disease, highlighting the key study results that have led to its current licensing and use.
直接口服抗凝剂(DOACs)在临床环境中越来越多地用于有静脉血栓栓塞(VTE)和/或中风风险的患者。这些药物长期使用具有重要益处,包括抗凝起效快、抗凝作用稳定(以及相应的特定剂量处方)且无需常规监测。阿哌沙班是一种选择性Xa因子抑制剂,被批准用于预防非瓣膜性心房颤动患者的中风以及预防和治疗急性VTE。与许多DOACs一样,它起效迅速,能产生可预测的凝血结果。包括ARISTOTLE和AMPLIFY在内的多项随机对照试验表明,在预防中风和VTE方面,阿哌沙班不劣于维生素K拮抗剂,且安全性良好。本文旨在综述阿哌沙班在预防和治疗血栓栓塞性疾病中的应用,重点介绍导致其目前获批和使用的关键研究结果。