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目前利伐沙班在老年静脉血栓栓塞症(VTE)患者中的应用。

Current use of rivaroxaban in elderly patients with venous thromboembolism (VTE).

机构信息

Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Chongqing Medical University, Chongqing, China.

出版信息

J Thromb Thrombolysis. 2021 Oct;52(3):863-871. doi: 10.1007/s11239-021-02415-5. Epub 2021 Mar 5.

Abstract

Venous thromboembolism (VTE), which is characterized by pulmonary embolism and deep vein thrombosis, has become a serious public concern. Notably, over half of the patients with VTE are over 70 years of age, but elderly patients are at high risk of anti-coagulation and bleeding, which increase with age. Moreover, risk factors and frailty also show a difference between elderly patients and ordinary patients diagnosed with VTE. Rivaroxaban is a direct inhibitor of activated factor Xa and has the advantage of predictable pharmacodynamics and pharmacokinetics, no coagulation monitoring, and few drug interactions. As a first-line therapy for VTE, this drug is more advantageous than traditional therapy and exhibits good efficacy and safety for ordinary patients. However, the effectiveness and safety of rivaroxaban in elderly patients have not been fully elucidated. This article reviewed the use of rivaroxaban in elderly patients, including drug interactions, monitoring, reversal agents of rivaroxaban, and the use of small dosages of rivaroxaban in elderly patients.

摘要

静脉血栓栓塞症(VTE)的特征为肺栓塞和深静脉血栓形成,已成为严重的公共卫生问题。值得注意的是,超过一半的 VTE 患者年龄在 70 岁以上,但老年患者存在抗凝和出血风险,且风险随年龄增加而增加。此外,老年患者与普通 VTE 患者的风险因素和虚弱程度也存在差异。利伐沙班是一种直接的 Xa 因子激活抑制剂,具有可预测的药效学和药代动力学、无需凝血监测和较少药物相互作用的优点。作为 VTE 的一线治疗药物,该药比传统治疗更具优势,对普通患者具有良好的疗效和安全性。然而,利伐沙班在老年患者中的有效性和安全性尚未完全阐明。本文综述了利伐沙班在老年患者中的应用,包括药物相互作用、监测、利伐沙班的逆转剂以及小剂量利伐沙班在老年患者中的应用。

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