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ETNA-VTE 欧洲研究:前 3 个月使用依度沙班治疗静脉血栓栓塞症的获益与风险。

ETNA-VTE Europe: Benefits and risks of venous thromboembolism treatment using edoxaban in the first 3 months.

机构信息

Internal and Cardiovascular Medicine-Stroke Unit, University of Perugia, Perugia, Italy.

Division of Angiology, Medical Clinic IV, University Hospital, Ludwig-Maximilians-University, Munich, Germany.

出版信息

Thromb Res. 2020 Dec;196:297-304. doi: 10.1016/j.thromres.2020.09.001. Epub 2020 Sep 12.

Abstract

INTRODUCTION

Edoxaban had a positive risk-benefit ratio for the treatment of venous thromboembolism (VTE) compared to conventional therapy with warfarin. The objective of this analysis of the ongoing ETNA-VTE Europe study was to assess the real-world benefits and risks of edoxaban during the first 3 months of treatment, the highest risk period for further VTE events.

METHODS

ETNA-VTE Europe is a prospective, non-interventional, post-authorization study, conducted in eight European countries. Participants had initial or recurrent acute VTE (deep vein thrombosis [DVT] and/or pulmonary embolism [PE]) that occurred ≤2 weeks prior to enrolment and received edoxaban therapy.

RESULTS

The analysis set included 2672 patients (PE ± DVT, n = 1117; DVT only, n = 1555); mean age 62.9 ± 16.0 years, bodyweight 81.9 ± 17.4 kg, estimated glomerular filtration rate 95.4 ± 42.8 mL/min; 46.4% were female. Overall, 66.4% of patients (PE ± DVT, 68.5%; DVT-only, 64.8%) received heparin lead-in treatment for at least 5 days. Most patients (87.7%) received edoxaban at a dose of 60 mg once daily. Event rates at 3 months were: recurrent VTE 0.34% (n = 9), major bleeding 0.97% (n = 26), all-cause mortality 0.79% (n = 21). Rates were numerically higher in the PE ± DVT group compared with the DVT-only group (recurrent VTE, 0.45% (n = 5) versus 0.26% (n = 4); major bleeding, 1.34% (n = 15) versus 0.71% (n = 11); and all-cause mortality 1.16% (n = 13) versus 0.51% (n = 8)).

CONCLUSIONS

The results support the safety and effectiveness of edoxaban in a general VTE population during the most critical time period, the first 3 months. The outcomes of this study extend the principal efficacy and safety data on edoxaban into the routine clinical practice setting.

摘要

介绍

与华法林的常规治疗相比,依度沙班在治疗静脉血栓栓塞症(VTE)方面具有积极的风险效益比。本项正在进行的 ETNA-VTE Europe 研究的分析旨在评估依度沙班在治疗的头 3 个月(即发生进一步 VTE 事件的最高风险期)的真实获益和风险。

方法

ETNA-VTE Europe 是一项在 8 个欧洲国家开展的前瞻性、非干预性、上市后研究。参与者患有≤2 周前入组时发生的初始或复发性急性 VTE(深静脉血栓形成[DVT]和/或肺栓塞[PE]),并接受依度沙班治疗。

结果

分析集包括 2672 例患者(PE±DVT,n=1117;DVT 仅,n=1555);平均年龄 62.9±16.0 岁,体重 81.9±17.4kg,估算肾小球滤过率 95.4±42.8mL/min;46.4%为女性。总体而言,66.4%的患者(PE±DVT,68.5%;DVT 仅,64.8%)接受了至少 5 天的肝素导入治疗。大多数患者(87.7%)依度沙班的剂量为 60mg,每日一次。3 个月时的事件发生率为:复发性 VTE 0.34%(n=9)、大出血 0.97%(n=26)、全因死亡率 0.79%(n=21)。PE±DVT 组与 DVT 仅组相比,发生率呈数值性升高(复发性 VTE,0.45%(n=5)vs. 0.26%(n=4);大出血,1.34%(n=15)vs. 0.71%(n=11);全因死亡率,1.16%(n=13)vs. 0.51%(n=8))。

结论

这些结果支持在最关键的前 3 个月,依度沙班在一般 VTE 人群中的安全性和有效性。本研究的结果将依度沙班的主要疗效和安全性数据扩展到常规临床实践环境中。

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