UCSG
My name is israel mauret and i’m going to talk about two epic seven to prevent venus thromboembolisms in patients with cancer definition apixaban is anticoagulant used to treat and prevent blood clots and to prevent the stroke in people with atrial fibrillation specifically it is used to prevent bloat clots following hip or knee replacement and in the dose with
A history of pure clot it is used as an alternative to warfarin and those not require monitoring by load test it is taken by mode patients with cancer have an increased risk of venous thromboembolism but parenteral thromboprophylaxis is not routinely recommended in practice guidelines because the absolute risk reduction is modest and parental thromboprophylaxis
Is associated with an increased risk of major bleeding as well as the inconvenience of daily injections could a direct oral anticoagulant such as apixaban used as a thromboprophylactic agent in patients with cancer offer advantages over parenteral agents particularly with regard to convenience the randomized placebo-controlled double-blind avert trial included
Ambulatory patients with cancer who are at intermediate to high risk for venous thromboembolism with a karana score of two or more the karana score has been validated to identify patients with cancer who are at elevated risk for thromboembolism the trial patients were randomized to apixaban for thromboprophylaxis before chemotherapy or to placebo before chemotherapy
The primary outcome was objectively documented venous thromboembolism over a period of 180 days in a modified intention to treat analysis venous thromboembolism occurred in 4.2 percent of the 288 patients in the apixaban group and 10.2 percent of the 275 patients in the placebo group the number needed to treat to prevent venous thromboembolism was 17. the main
Safety outcome was major bleeding major bleeding occurred in 10 patients in the apixaban group and five patients in the placebo group the authors conclude that apixaban at the initiation of chemotherapy resulted in significantly lower rates of venous thromboembolism than did placebo among intermediate to high-risk ambulatory patients with cancer the rate of major
Bleeding episodes was higher with apixaban than with placebo full trial results are available at nejm.org application in medicine to lower the risk of a stroke and then balance in people with non-bubbler atrial fibrillation second deep vented thrombosis probations dvt is met late to pulmonary embolism in knee or hip replaces immense surgery patterns treatment of
Both dbt and pe and to reduce the risk of recurring dvt and pe after initial therapy pros and cons plus the use of direct anticoagulants as thromboprophylaxis agents in patients with cancer can offer advantage over parenteral agents including road of administration convenience and cost cons big 7 can increase the risk of bleeding which may be serious potentially
Fatal when spinal epidural anesthesia or puncture is used patients who are being treated with antithrombotic atoms for the prevention of thromboembolic complications art risk for developing a hematoma which can cause long-term or payment paralysis so issues applied in ecuador in ecuador apixaban is using for therapeutics of herd fighter and other adults
Other application is for stroke prevention in non-bubbler atrial fibrillation in public healthcare sector in conclusion appixaman therapy resulted in a significantly lower rate of bench thromboembolisms than did placebo among intermittent to rise risk ambulatory patterns with cancer who were starting chemotherapy the rate of major bleeding episode was higher with
Apex van that with placebo but we know that there’s so many folks in the octogenarian plus group and we also know that a lot of folks are being fearful of treating them with therapeutic anticoagulation so and then if you do that which one this is a pretty generalizable type thing because in this analysis it was 38 percent of the united states population
Essentially with 123 million lives when you looked at cms plus three commercial claims databases of humana optum and farm metrics thanks
Transcribed from video
APIXABAN TO PREVENT VENOUS THROMBOEMBOLISM IN PATIENTS WITH CANCER By israel maurath
