Dabigatran – skuteczny lek o potwierdzonej skuteczności i dobrym profilu bezpieczeństwa Opis przypadku
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Opublikowane:
gru 31, 2024
Słowa kluczowe:
leczenie przeciwkrzepliwe, DOAC, idarucyzumab, dabigatran, migotanie przedsionków
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Abstrakt
Dabigatran jest bezpośrednim inhibitorem trombiny o udowodnionej skuteczności w redukcji ryzyka zdarzeń zakrzepowo-zatorowych i – co ważne – mającym swoiste antidotum, jakim jest idarucyzumab. Niniejszy przegląd omawia kliniczne zastosowanie dabigatranu u pacjentów z migotaniem przedsionków, zwłaszcza z wywiadem udaru mózgu, oraz u osób wymagających nagłego odwrócenia działania antykoagulacyjnego. Ponadto prezentuje rolę dabigatranu u pacjentów z chorobą wątroby. Pomimo unikatowych korzyści lek wymaga starannego doboru pacjentów ze względu na zależność od czynności nerek oraz konieczność dawkowania 2 razy dziennie.
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Jak cytować
Skwarek, A., & Ozierański, K. (2024). Dabigatran – skuteczny lek o potwierdzonej skuteczności i dobrym profilu bezpieczeństwa . Medycyna Faktów , 17(4(65), 565-569. https://doi.org/10.24292/01.MF.0424.21
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Bibliografia
1. Connolly SJ, Ezekowitz MD, Yusuf S et al. Dabigatran versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med. 2009; 361(12): 1139-51.
2. Risks for Stroke, Bleeding, and Death in Patients With Atrial Fibrillation Receiving Dabigatran or Warfarin in Relation to the CHADS2 Score: A Subgroup Analysis of the RE-LY Trial. Ann Intern Med. 2011; 155(10): 660-7.
3. Panichpisal K, Szarek M, Sareen A. Dabigatran for stroke prevention in patients with atrial fibrillation and previous stroke or transient ischemic attack: does dose matter? Fut Neurol. 2011; 6: 155-8.
4. Kubota K, Ooba N. Effectiveness and Safety of Reduced and Standard Daily Doses of Direct Oral Anticoagulants in Patients with Nonvalvular Atrial Fibrillation: A Cohort Study Using National Database Representing the Japanese Population. Clin Epidemiol. 2022; 14: 623-39.
5. Alberts MJ, Bernstein RA, Naccarelli GV et al. Using dabigatran in patients with stroke: a practical guide for clinicians. Stroke. 2012; 43(1): 271-9.
6. Werring DJ, Dehbi HM, Ahmed N et al.; OPTIMAS investigators. Optimal timing of anticoagulation after acute ischaemic stroke with atrial fibrillation (OPTIMAS): a multicentre, blinded-endpoint, phase 4, randomised controlled trial. Lancet. 2024 Oct 23: S0140-6736(24)02197-4.
7. Steffel J, Collins R, Antz M et al. 2021 European Heart Rhythm Association Practical Guide on the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation. Europace. 2021; 23(10): 1612-76.
8. Pollack CV, Reilly PA, van Ryn J et al. Idarucizumab for Dabigatran Reversal – Full Cohort Analysis. N Engl J Med. 2017; 377(5): 431-41.
9. van der Wall SJ, van Rein N, van den Bemt BJF et al. Performance of idarucizumab as antidote of dabigatran in daily clinical practice. EP Europace. 2018; 21: 414-20.
10. Violi F, Vestri A, Menichelli D et al. Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Advanced Liver Disease: An Exploratory Meta‐Analysis. Hepatology Communications. 2020; 4: 1034-40.
11. Khalid A, Mautong H, Hasnol H, Njei B. S1589 Risks and Benefits of DOACS vs Warfarin in Patients With AF and Liver Disease – A Systematic Review and Meta-Analysis. Am J Gastroenterol. 2023; 118: S1201-2.
12. Lee S-R, Lee H-J, Choi EK et al. Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Liver Disease. J Am Coll Cardiol. 2019; 73(25): 3295-308.
13. Elhosseiny S, Al Moussawi H, Chalhoub JM et al. Direct Oral Anticoagulants in Cirrhotic Patients: Current Evidence and Clinical Observations. Can J Gastroenterol Hepatol. 2019; 2019: 4383269.
2. Risks for Stroke, Bleeding, and Death in Patients With Atrial Fibrillation Receiving Dabigatran or Warfarin in Relation to the CHADS2 Score: A Subgroup Analysis of the RE-LY Trial. Ann Intern Med. 2011; 155(10): 660-7.
3. Panichpisal K, Szarek M, Sareen A. Dabigatran for stroke prevention in patients with atrial fibrillation and previous stroke or transient ischemic attack: does dose matter? Fut Neurol. 2011; 6: 155-8.
4. Kubota K, Ooba N. Effectiveness and Safety of Reduced and Standard Daily Doses of Direct Oral Anticoagulants in Patients with Nonvalvular Atrial Fibrillation: A Cohort Study Using National Database Representing the Japanese Population. Clin Epidemiol. 2022; 14: 623-39.
5. Alberts MJ, Bernstein RA, Naccarelli GV et al. Using dabigatran in patients with stroke: a practical guide for clinicians. Stroke. 2012; 43(1): 271-9.
6. Werring DJ, Dehbi HM, Ahmed N et al.; OPTIMAS investigators. Optimal timing of anticoagulation after acute ischaemic stroke with atrial fibrillation (OPTIMAS): a multicentre, blinded-endpoint, phase 4, randomised controlled trial. Lancet. 2024 Oct 23: S0140-6736(24)02197-4.
7. Steffel J, Collins R, Antz M et al. 2021 European Heart Rhythm Association Practical Guide on the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation. Europace. 2021; 23(10): 1612-76.
8. Pollack CV, Reilly PA, van Ryn J et al. Idarucizumab for Dabigatran Reversal – Full Cohort Analysis. N Engl J Med. 2017; 377(5): 431-41.
9. van der Wall SJ, van Rein N, van den Bemt BJF et al. Performance of idarucizumab as antidote of dabigatran in daily clinical practice. EP Europace. 2018; 21: 414-20.
10. Violi F, Vestri A, Menichelli D et al. Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Advanced Liver Disease: An Exploratory Meta‐Analysis. Hepatology Communications. 2020; 4: 1034-40.
11. Khalid A, Mautong H, Hasnol H, Njei B. S1589 Risks and Benefits of DOACS vs Warfarin in Patients With AF and Liver Disease – A Systematic Review and Meta-Analysis. Am J Gastroenterol. 2023; 118: S1201-2.
12. Lee S-R, Lee H-J, Choi EK et al. Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Liver Disease. J Am Coll Cardiol. 2019; 73(25): 3295-308.
13. Elhosseiny S, Al Moussawi H, Chalhoub JM et al. Direct Oral Anticoagulants in Cirrhotic Patients: Current Evidence and Clinical Observations. Can J Gastroenterol Hepatol. 2019; 2019: 4383269.