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| 標題: | Off-label reduced-dose apixaban does not reduce hemorrhagic risk in Taiwanese patients with nonvalvular atrial fibrillation A retrospective, observational study |
| 作者: | Chen, I-Chih
Chang, Wei-Ting
Hsu, Po-Chao
Yeh, Ya-Lan
Zheng, Syuan
Huang, Yuan-Chi
Lin, Chih-Hsien
Tsai, Liang-Miin
Lin, Li-Jen
Liu, Ping-Yen
Liu, Yen-Wen |
| 貢獻者: | Tainan Municipal Hosp, Div Cardiol, Dept Internal Med
Chia Nan Univ Pharm & Sci, Dept Pharm
Chi Mei Med Ctr, Div Cardiol, Dept Internal Med
Southern Taiwan Univ Sci & Technol, Dept Biotechnol
Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Div Cardiol, Dept Internal Med
Chang Gung Univ Sci & Technol, Chiayi Campus
Natl Cheng Kung Univ Hosp, Dept Med
Natl Cheng Kung Univ Hosp, Dept Internal Med, Div Cardiol
Natl Cheng Kung Univ, Coll Med, Inst Clin Med |
| 關鍵字: | direct oral anticoagulant
nonvalvular atrial fibrillation
off-label reduced-dose apixaban
stroke |
| 日期: | 2021 |
| 上傳時間: | 2023-11-11 11:50:20 (UTC+8) |
| 出版者: | LIPPINCOTT WILLIAMS & WILKINS |
| 摘要: | East Asians are reportedly at high risk of anticoagulant-related bleeding; therefore, some physicians prefer to prescribe low-dose direct oral anticoagulants (DOACs). Little is known about the therapeutic effectiveness and safety of off-label reduced-dose apixaban in East Asians with nonvalvular atrial fibrillation (AF). We aimed to investigate the effectiveness and safety of off-label reduced-dose apixaban in Taiwanese patients with nonvalvular AF. This retrospective cohort study enrolled 1073 patients with nonvalvular AF who took apixaban between July 2014 and October 2018 from 4 medical centers in southern Taiwan. The primary outcomes included thromboembolic events (stroke/transient ischemic attack or systemic embolism), major bleeding, and all-cause mortality. Among all patients, 826 (77%) patients were classified as the per-label adequate-dose treatment group (i.e., consistent with the Food and Drug Administration label recommendations) while 247 (23%) patients were the off-label reduced-dose treatment group. The mean follow-up period was 17.5 +/- 13 months. The off-label reduced-dose group did not have a lower major bleeding rate than the per-label adequate-dose group (4.8% vs 3.8%, adjusted hazard ratio [HR] 1.20, 95% confidence interval [CI] 0.69-2.09), but had a nonsignificantly higher incidence of thromboembolic events (4.23% vs 3.05%, adjusted HR: 1.29, 95% CI: 0.71-2.34). An off-label reduced-dose apixaban treatment strategy may not provide incremental benefits or safety for Taiwanese patients with nonvalvular AF. |
| 關聯: | MEDICINE, v.100, n.23, e26272 |
| 顯示於類別: | [藥學系(所)] 期刊論文
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