Hello my name is marie pereneza castro i am the student of mason and i am going to expose you about apixaban to prevent venus from wind blimps in patients with cancer definition venus from bumbolim’s bta is an important cause of morbidity and mortality in cancer patients while anticoagulation for vta associated with cancer is limited to vitamin k abk and
Apparent antagonist for several decades as a new therapeutic option and direct oral anticoagulants have recently emerged venous thromboembolism is a common complication of cancer while subcutaneous low molecular weight heparin is the standard treatment for cancer-associated venous thromboembolism the role of direct oral anticoagulants is unclear a randomized open
Label non-inferiority study of 1046 patients with cancer and confirmed venous thromboembolism tested the efficacy of anticoagulant therapy for up to 12 months one group was treated with subcutaneous low molecular weight heparin for at least five days followed by 60 milligrams of oral edoxaban once daily the other group received 200 iu of subcutaneous parent per
Kilogram once daily for one month followed by 150 iu per kilogram thereafter the primary outcome a composite of recurrent venous thromboembolism or major bleeding event during the 12-month follow-up occurred in 12.8 percent of the patients receiving edoxaban as compared with 13.5 percent of the patients receiving daltoperin statistically this result demonstrated
The non-inferiority of edoxaban to daltoperin but did not demonstrate its superiority recurrent venous thromboembolism occurred in seven point nine percent of the patients receiving edoxaban as compared with eleven point three percent of those receiving daltoperin and major bleeding occurred in six point nine percent of the patients receiving edoxaban as compared
With 4.0 percent of those receiving daltoperin the authors conclude that in patients with cancer and venous thromboembolism oral edoxaban was non-inferior to subcutaneous daltoperin for preventing the composite outcome of recurrent venous thromboembolism or major bleeding edoxaban’s lower rate of recurrent thromboembolism was offset by an increased risk of major
Bleeding full trial results are available at nejm.org the new england journal of medicine application amazing patients without tips cancer have an increased risk of venous from volumes and which results in substantial morbidity morbidity and mortality and healthcare expanded and the quran core range of 2-6 with higher score indication in higher risk of venus
From wembleins has been validated into in the entire patients with cancer at elevated risk for this complication and may help select those who call benefit from thrombo for prophylaxis medicines like and rivaroxaban apixaban etc they belong to a class of drugs called anticoagulants what these medicines do is they basically thin your blood especially if you have
A condition that predisposes you to form blood clots like an irregular heart rhythm or you’ve had blood clots in your legs or your lungs or any other part of your body these medicines basically thin the blood in the body and because your blood gets thin you have a higher tendency to bleed so you may bruise easily or you may injure yourself and you may bleed a
Little bit more than normal so it’s important when you take these medicines try and avoid any contact spot or try and avoid anything where you injure yourself and you will bleed more pros and cons does not need monitoring of patients international normalization radio predictable pharmacogenetics and pharmacodynamics and the risk of mireblading is three percent or
Less and clinically relevant now your vladimir is two persons to four persons by now the safety and efficacy of the no wax is pretty well established but little is known about the impact of appropriate dosing on the effectiveness and safety of a pixaband and a rivaroxaban which is what we’re talking about specifically in patients in real world practice so we’re
Here to discuss the revisit u.s study and it’s real-world evidence of stroke prevention in patients with non-valvular atrial fibrillation to the united states and to do so i’m with dr paul burton who is an md and a phd and a vice president of medical affairs at janssen now this is data that’s being presented the european cardiac arrhythmia society in paris tell
Me a little bit about the trial first off yes so the revisit u.s study is a very interesting study for us it’s just under 31 000 patients so it’s large it’s a real world claims database analysis and it compares rivaroxaban to warfarin and a pixar bound to in and it asks a question what are the rates of important clinical events irreversible harm so intracranial
Hemorrhage and ischemic stroke these are the events that we know physicians and patients fear most what are the rates of those in real world practice so the results are fascinating what we find is that the rates of intracranial hemorrhage are reduced by 47 significantly for rivaroxaban versus warfarin and we find that the rates of ischemic stroke for rivaroxaban
Versus warfarin are reduced by 29 but it’s just not significant these are data coming from what a couple of trials that you’re using data from aristotle and the registration trial for pixaband and rocket af which was the registration trial for rivaroxaban correct so rocket af was the uh registration trial for rivaroxaban aristotle was the registration trial for
Pixaband so these numbers though are what we’re now finding in the real world so they’re very encouraging and really demonstrate the continued utility of rivaroxaban xor alto in the real world in afib patients now in terms of dosing because that’s kind of the interesting area where we haven’t had a whole lot of data to before what did you find there well the
Interesting thing is so we find a reduction in intracranial hemorrhage and ischemic stroke for rheumatoid versus warfarin with a pixaband there’s also a reduction in the rate of intracranial hemorrhage a small 13 non-significant increase in the rate of ischemic stroke we know that there are differences in adherence with twice daily and once daily drugs we know
That patients also our physicians prescribe different doses of drugs so it’s an interesting finding because it now looks it tries to integrate real world use of these agents with clinical outcome and again we find very robust consistent reduction in these important events with cerrelto so is there a lesson to be learned i mean doctors are really concerned about
The risk of bleeding and of course patients need to be concerned about not only that but also the potential down the line of a stroke so in terms of dosing what can you say about a lesson learned from this i think we published a study a while ago that showed that patients and physicians fear stroke almost as much as they fear dying we believe that you must not
Trade off a reduction in bleeding which is preventable and is treatable with reduction in an event that is irreversible so a stroke i think what we see here in this study for the first time is again consistent reduction in these endpoints for zoroto taking drugs appropriately there’s a very famous quote by c everett coop that drugs don’t work in patients who
Don’t take them right and it’s true cerealto is a robust once daily medicine and it continues to demonstrate it’s it’s great clinical utility here now in the real world just as it did in the randomized studies were you able to look at how well doctors are following the guidelines in terms of dosing we haven’t looked at that here we are our work certainly is not
Done we continue to do that we have 91 000 patients now in real world studies and you you know as well as i do that um this explorer program of ours when all said and done we’ll have 275 000 patients enrolled in new indication seeking trials as well as well as real world evidence and i think that when all said and done we’ll we’ll be able to really definitively
Answer that question but these data are provocative and application inequality the entrance to the pharmaceutical market of new alien or atlantic oil and that do not require adjustments induced monitoring by periodic blood tests and open an excellent opportunity for the launch of a pixelman this information is provided for public education purposes only and is not
Intended to substitute for a manufacturer’s directions or consultation with a licensed pharmacist or healthcare professional all medication including those available over the counter can be harmful if not used as directed and taking more than one medication could result in harmful drug interactions please consult a licensed pharmacist or health care professional
Before taking any medication or changing an already approved or prescribed medication plan hi my name is levi and i’m a student pharmacist here at the university of arkansas for medical sciences today i’m going to talk to you about your medication apixaban a pig span is also known by its brand name eliquis a pixaband is a medication used to treat blood clots and
To thin the blood to prevent clots from forming in the bloodstream fix a ban is usually taken by mouth with or without food and most commonly twice a day if you miss a dose take the mist dose as soon as you think about it if it is close to the time for your next dose skip that dose and resume your normal dosing schedule do not take two doses at the same time or
Extra doses some common side effects with apixaban include hemorrhage nausea and bruising and some less common side effects include skin rash and tiredness while taking a pixel band remember it is important to tell your doctor or pharmacist if you have signs of an allergic reaction a spinal or epidural procedure because some time may need to pass between the use
Of this drug and your procedure if you have any signs of nerve problems like back pain numbness or tingling muscle weakness paralysis or loss of bladder or bowel control if you have any signs of bleeding problems like bruising black tarry or bloody stools bleeding gums blood in the urine coughing up blood cuts that take a long time to stop and is not intended
To substitute for a manufacturer’s directions or consultation with a licensed pharmacist or health care professional all medication including those available over the counter can be harmful if not used as directed and taking more than one medication could result in harmful drug interactions please consult a licensed pharmacist or health care professional before
Taking any medication or changing an already approved or prescribed medication plan in conclusion a pixel entrap results in a significantly lower rate of venus from wembley leaves then these placebo mornings were made to high-risk ambulatory patients with cancer who were searching chemotherapy the rate of major episodes was however with a big seventh then with
Plus seven so so thank you you
Transcribed from video
Apixaban to prevents venous tromboembolism patients with cancer By Pierina Zambrano
