Munevar Aquite Oriana, Hayes Michael, Beyene Kebede, Chan Amy Hai Yan, Schauer Cameron, Wei Henry, Gong Jiayi
School of Pharmacy, Faculty of Medical and Health Science, The University of Auckland, New Zealand.
Department of Gastroenterology, Waitematā District Health Board, New Zealand.
N Z Med J. 2022 Oct 7;135(1563):52-61. doi: 10.26635/6965.5832.
The safety of dabigatran is poorly studied in patients with liver cirrhosis and has rarely been compared to warfarin in terms of bleeding risks.
We undertook a retrospective cohort study across three tertiary centres in Auckland, New Zealand, between 2008 to 2020. Adults 18 years and over and those with a clinically confirmed diagnosis of cirrhosis were included. Data collected included demographic data and clinical characteristics, baseline medication and comorbidities. The primary outcome measure was the incidence of any bleeding event that resulted in hospital admission.
Overall, 100 patients were included in this study. A total of 52 patients took warfarin, and 48 took dabigatran. Baseline characteristics for both groups were generally similar. The incidence rate of bleeds for patients taking warfarin was 14.4 per 100 person-years (95% CI, 8.8-23.5) compared to 9.1 per 100 person-years (95% CI, 4.5-18.1) for patients taking dabigatran. The incidence rate ratio comparing dabigatran to warfarin was 0.63 (95% CI, 0.23-1.60), p=0.25.
Our study found that patients on dabigatran may have a lower bleeding risk than patients taking warfarin, but this was not statistically significant.
达比加群在肝硬化患者中的安全性研究较少，且在出血风险方面很少与华法林进行比较。
我们在2008年至2020年期间对新西兰奥克兰的三个三级中心进行了一项回顾性队列研究。纳入18岁及以上的成年人以及临床确诊为肝硬化的患者。收集的数据包括人口统计学数据和临床特征、基线用药情况和合并症。主要结局指标是导致住院的任何出血事件的发生率。
总体而言，本研究共纳入100例患者。共有52例患者服用华法林，48例服用达比加群。两组的基线特征总体相似。服用华法林的患者出血发生率为每100人年14.4例（95%CI，8.8 - 23.5），而服用达比加群的患者为每100人年9.1例（95%CI，4.5 - 18.1）。达比加群与华法林的发生率比为0.63（95%CI，0.23 - 1.60），p = 0.25。
我们的研究发现，服用达比加群的患者出血风险可能低于服用华法林的患者，但这在统计学上无显著差异。
