Apixaban Inconsistent on Stopping Stroke
A new study suggests that Apixaban may not stop a stroke in patients on maintenance dialysis as well as in patients who have new-onset nonvalvular atrial fibrillation. The drug may even increase the risk of bleeding,s.
According to recent research on Apixaban, (a direct oral anticoagulant (DOAC), it outperformed warfarin, a vitamin K antagonist, in patients with kidney malfunction.
Thomas A. Mavrakanas, BS, MB, of Brigham & Women’s Hospital in Boston, and colleagues, matched 521 apixaban recipients from the 2012-2015 US Renal Data System (USRDS) to 1561 patients not treated with any anticoagulant by demographics, relevant comorbidities, and use of antihypertensives, statins, and antiplatelets.
The database did not obtain aspirin usage, blood pressure control, body mass index, residual kidney function, dialysis prescription, and anticoagulation prescription during dialysis.
Apixaban use was not associated with a lower incidence of the primary endpoint.
Dr. Mavrakanas’ team found a notable 2.7-fold larger incidence of fatal or intracranial bleeding with apixaban compared with no treatment.
They also observed a comparable incidence of clinically important bleeding, defined as resulting in death, occurring in the gastrointestinal, urinary tract, or gynecologic regions, and requiring hospitalization.
In subgroup analyses, the standard apixaban dose (5 mg twice a day) was associated with a higher rate of the initial outcome and a higher incidence of fatal or intracranial bleeding and hemorrhagic stroke. The reduced apixaban dose (2.5 mg twice a day) was not.
The investigators noted that stroke mechanisms are different in patients with kidney failure, with more hemorrhagic stroke.
Eliquis (Apixaban) is made by Bristol-Myers Squibb within an Anti-coagulant in the USA. Is a anticoagulant used for treating venous thromboembolic Occasions and is taken orally.
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