JAMA Neurol:达比加群vs华法林用于脑静脉血栓患者静脉血栓事件的预防

2019-09-10 MedSci MedSci原创

研究发现,CVT抗凝患者中使用达比加群或华法林后,复发VTEs的风险都很低,而且出血的风险相似,表明达比加群和华法林对预防CVT患者复发性VTEs都是安全和有效的

脑静脉血栓 (CVT)患者的复发静脉血栓事件(VTEs)风险增加。近日研究人员比较达比加群与华法林对预防CVT患者复发性VTEs的疗效和安全性。

RE-SPECT CVT于2016年12月21日至2018年6月22日在9个国家(法国、德国、印度、意大利、荷兰、波兰、葡萄牙、俄罗斯和西班牙)开展。接受肠外肝素治疗5-15天后稳定的成人急性CVT患者参与。随机接受达比加群,每日两次150mg,或者剂量调整华法林治疗24周。研究的主要终点为新的VTE(复发性CVT、任何肢体深静脉血栓形成、肺栓塞和内脏静脉血栓形成)或大出血的患者。次要结果是脑静脉再通和临床相关的非主要出血事件。

总计120例CVT患者, 60例为达比加群组和60例华法林组,平均年龄45.2岁,66名女性。达比加群的暴露持续时间为22.3周,华法林组为23.0周,未观察到复发VTEs。在华法林组中记录了1例(1.7%)肠道出血事件和2例(3.3%)颅内出血。华法林组发生1例(1.7%)临床相关的非大出血事件。达比加群33例患者(60.0%)和华法林组中35例患者(67.3%)发生再通。

研究发现,CVT抗凝患者中使用达比加群或华法林后,复发VTEs的风险都很低,而且出血的风险相似,表明达比加群和华法林对预防CVT患者复发性VTEs都是安全和有效的。

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    2020-08-02 fusion
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    2020-05-06 yinhl1978
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    2020-08-15 xue8602

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