Dabigatran – an effective drug with proven efficacy and a high safety profile Case report
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Published:
Dec 31, 2024
Keywords:
anticoagulation, DOAC, idarucizumab, dabigatran, atrial fibrillation
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Abstract
Dabigatran is a direct thrombin inhibitor with proven efficacy in reducing thromboembolic events and, importantly, a specific antidote – idarucizumab. This review highlights the clinical use of dabigatran in patients with atrial fibrillation, especially those with a history of stroke, and patients requiring urgent reversal of anticoagulation. Additionally, dabigatran’s role in patients with liver disease is discussed. Although it offers unique advantages, careful patient selection is necessary due to the drug’s renal dependence and twice-daily dosing schedule.
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How to Cite
Skwarek, A., & Ozierański, K. (2024). Dabigatran – an effective drug with proven efficacy and a high safety profile. Medycyna Faktow (J EBM), 17(4(65), 565-569. https://doi.org/10.24292/01.MF.0424.21
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References
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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.