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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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