Friday, 23 Aug 2019

You are here

Risk of Major Gastrointestinal Bleeding With New vs Conventional Oral Anticoagulants

The comparative risk for gastrointestinal bleeding (GIB) with non-vitamin K antagonist oral anticoagulants (NOACs) was compared to vitamin K antagonists or anti-platelet agents in a recent metanalysis, which showed no significant difference in major GIB events between these agents.

A systematic review focused on 43 randomized controlled trials, 183,752 patients and 41 real-world studies (1,879,428 patients). NOACs include popular drugs such as  dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis). 

The pooled major rates of GIB were:

  • NOACs 1.19%
  • Conventional treatment 0.92%

Comparative results were not significant in randomized controlled trials or from real-world studies.

Rivaroxaban, but not other NOACs, was associated with an increased risk for major GIB (RR 1.39; 95% CI, 1.17-1.65 and RR 1.14; 95% CI, 1.04-1.23).

 

 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Vitamin D Supplements Fail to Prevent Type 2 Diabetes - DUH!

A NEJM report shows that the use of vitamin D3 supplementation (4000 IU per day) in those without diabetes or vitamin D deficiency failed to significantly lower risk of type 2 diabetes (compared to placebo).

The rational for this report included observational data showing an association between a low blood 25-hydroxyvitamin D level and the risk of type 2 diabetes.

Rituximab Superior to Cyclosporine for Membranous Nephropathy

The NEJM has reported that rituximab (RTX) and cyclosporine (CYA) was noninferior to cyclosporine in inducing complete or partial remission of proteinuria at 12 months and was superior in maintaining proteinuria remission up to 24 months. 

Management of Hemophagocytic Lymphohistiocytosis (HLH) in Adults

Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory syndrome induced by activated macrophages and cytotoxic T cells.  HLH manifests recurrent fever, cytopenia, liver dysfunction, and a sepsis-like syndrome that may complicated by multiple organ failure.

More Trouble for Mallinckrodt’s Acthar Gel

Reuters has reported that Mallinckrodt Plc has tentatively agreed to pay $15.4 million to resolve a US Justice Department investigation into company promotional practices for Acthar gel.

FDA Public Review of CBD Oil

The US Food and Drug Administration convened a public hearing and specialty panel on May 31st to review the potential use, safety and effectiveness of cannabidiol (CBD) products that do not contain THC.

In his opening remarks, the FDA acting Commissioner Dr. Ned Sharpless said, "critical questions remain about the safety" of CBD products, especially since the growth of the CBD market has exploded in the past year.