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利伐沙班口服制剂与标准疗法用于越南患者急性静脉血栓栓塞症治疗的比较

Oral Rivaroxaban Versus Standard Therapy in Acute Venous Thromboembolism Treatment for Vietnamese Patients.

作者信息

Bui My Hanh, Son Nguyen Truong, Viet Pham Thanh, Hiep Nguyen Hoang, Dinh Toi Chu

机构信息

Tuberculosis and Lung Disease Department, Hanoi Medical University, Hanoi, Vietnam.

Scientific Research & International Cooperation Department, Hanoi Medical University Hospital, Hanoi, Vietnam.

出版信息

Open Access Maced J Med Sci. 2019 Dec 20;7(24):4255-4259. doi: 10.3889/oamjms.2019.370. eCollection 2019 Dec 30.

Abstract

BACKGROUND

Direct oral anticoagulant-rivaroxaban may provide a simple, fixed-dose therapy for the management of hospital-acquired, acute venous thromboembolism (VTE) and for extended treatment, its use could skip lab observation and/or parenteral treatment.

AIM

Compare the efficacy and safety (EAS) of RIV vs. standard therapy (SDTD) in a cohort of Vietnamese patients diagnosed with symptomatic, acute VTE.

METHODS

An open-label, case-control, prospective study was conducted to check the efficacy and safety (EAS) of oral rivaroxaban (RIV) alone (15 mg 2 times/day for 3 weeks, then 20 mg 1 time/day) in a comparison to the standard therapy (STDT) (enoxaparin 1.0 mg/kg 2 times/day combining with vitamin K antagonist). Patients were treated for 6 months and followed-up for suspect reoccurring VTE and bleeding.

RESULTS

A total 187 patients were enrolled into study. 83 were provided rivaroxaban and 104 received enoxaparin overlapping with vitamin K antagonist (VKAs). Recurrent VTE occurred in 3 (3.6%) rivaroxaban-received patients compared with 5 (4.8%) standard-treatment received patients (OR: 0.74, 95% CI, 0.17 to 3.20, p > 0.05). Major bleeding events were found in 1 (1,8%) and 4 (3.9%) cases in the RIV treated and STDT cohort, respectively (OR: 0.30, 95% CI, 0.03 to 2.76, p > 0.05).

CONCLUSION

The finding of this study in Vietnamese patients with acute VTE presented comparable EAS profile with RIV versus STDT, consistent with those found in global population.

摘要

背景

直接口服抗凝药利伐沙班可为医院获得性急性静脉血栓栓塞症(VTE)的管理提供一种简单的固定剂量疗法,并且在延长治疗中,其使用可无需实验室监测和/或肠外治疗。

目的

比较利伐沙班(RIV)与标准疗法(SDTD)在一组诊断为有症状急性VTE的越南患者中的疗效和安全性(EAS)。

方法

开展一项开放标签、病例对照、前瞻性研究,以检查单独口服利伐沙班(RIV)(15毫克,每日2次,共3周,然后20毫克,每日1次)与标准疗法(STDT)(依诺肝素1.0毫克/千克,每日2次联合维生素K拮抗剂)相比的疗效和安全性(EAS)。患者接受6个月治疗,并对疑似复发性VTE和出血进行随访。

结果

共有187例患者纳入研究。83例接受利伐沙班治疗,104例接受依诺肝素与维生素K拮抗剂(VKAs)重叠治疗。接受利伐沙班治疗的患者中有3例(3.6%)发生复发性VTE,而接受标准治疗的患者中有5例(4.8%)发生复发性VTE(比值比:0.74,95%置信区间,0.17至3.20,p>0.05)。在RIV治疗组和STDT队列中,分别有1例(1.8%)和4例(3.9%)发生大出血事件(比值比:0.30,95%置信区间,0.03至2.76,p>0.05)。

结论

本研究在越南急性VTE患者中的发现表明,RIV与STDT的疗效和安全性概况具有可比性,与全球人群中的发现一致。

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Oral rivaroxaban for symptomatic venous thromboembolism.口服利伐沙班治疗有症状的静脉血栓栓塞症。
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本文引用的文献

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2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism.2014年欧洲心脏病学会急性肺栓塞诊断和管理指南
Eur Heart J. 2014 Nov 14;35(43):3033-69, 3069a-3069k. doi: 10.1093/eurheartj/ehu283. Epub 2014 Aug 29.

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