Použití rivaroxabanu v prevenci cévní mozkové příhody u nevalvulární fibrilace síní v praxi
Výsledky observačních studií a naše zkušenosti

Česká verzia

Authors: Filip Málek
Authors place of work: Kardiovaskulární centrum Nemocnice Na Homolce, Praha
Published in the journal: Vnitř Lék 2016; 62(10): 814-819
Category: Reviews

Summary

Rivaroxaban is direct oral factor Xa inhibitor indicated for tromboembolic event rate reduction in patients with non-valvular atrial fibrillation. Knowledge of rivaroxaban efficacy and safety comes from a phase III randomized clinical trial ROCKET AF. In the present, we have more evidence of rivaroxaban efficacy from real-life clinical studies. XANTUS study was first international prospective observational real-life study documenting use of rivaroxaban in stroke prevention in a broad population of patients with non-valvular atrial fibrillation. The incidence of major bleeding and tromboembolic events was in real clinical practice low. RELIEF study was a second important study describing use of rivaroxaban in real-life clinical practice. The aim of this rectrospective study was to compare effectiveness of newly indicated rivaroxaban treatment with the vitamin K antagonists treatment. Our experience shows low incidence of bleeding with this therapy too.

Key words:
anticoagulation therapy – non-valvular atrial fibrillation – real-life studies – rivaroxaban

Zdroje

1. European Medicines Agency (EMA). Xarelto.Summary of Product Characteristics. Updated 15 August 2013. Dostupné z WWW: http://www.ema.europa.eu/docs/it_IT/document_library/EPAR_-_Product_Information/human/000944/WC500057108.pdf.

2. Penka M. Rivaroxaban a inhibitory faktoru Xa v klinické praxi. Vnitř Lék 2010; 56(9): 920–926.

3. Anderson JL, Halperin JL, Albert NM et al. [ACC/AHA Task Force Members]. 2014 AHA/ACC/HRS Guideline for the Management of Patients with Atrial Fibrillation: Executive Summary. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014; 64(21): 2246–2280. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2014.03.021>.

4. Patel MR, Mahaffey KW, Garg J et al. [ROCKET AF Investigators]. Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation. New J Engl Med 2011; 365(10): 883–891. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1009638>.

5. Camm AJ, Amarenco P, Haas S et al. XANTUS: a real-world, prospective, observational study of patients treated with rivaroxaban for stroke preventiv in atrial fibrillation. Eur Heart J 2016; 37(14): 1145–1153. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehv466>.

6. Coleman CI, Antz M, Ehlken B et al. Real-Life Evidence of stroke prevention in patients with atrial fibrillation – The RELIEF study. Int J Cardiol 2016; 203: 882–884. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ijcard.2015.09.037>.

7. Sardar P, Chatterjee S, Chaudhari S et al. New oral anticoagulants in elderly adults: evidence from a meta-analysis of randomized trials. J Am Geriatr Soc 201; 62(5): 857–864. Dostupné z DOI: <http://dx.doi.org/10.1111/jgs.12799>.

8. Abraham NS, Singh S, Alexander GC et al. Comparative risk of gastrointestinal bleeding with dabigatran, rivaroxaban, and warfarin: population based cohort study. BMJ 2015; 350: h1857. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.h1857>.

9. Barón-Esquivias G, Ferníndez-Avilés F, Atienza F et al. Efficacy and safety of rivaroxaban in real-life patients with atrial fibrillation. Expert Rev Cardiovasc Ther 2015; 13(14): 341–353. Dostupné z DOI: <http://dx.doi.org/10.1586/14779072.2015.1026259>.