OI 10.2450/2017.0196-SIMTI Servizi SrlTIBackground. Direct oral anticoagulants (DOAC) have already been shown
OI 10.2450/2017.0196-SIMTI Servizi SrlTIBackground. Direct oral anticoagulants (DOAC) have been shown to be non-inferior to conventional vitamin K antagonists in preventing stroke and arterial thromboembolism in individuals with non-valvular atrial fibrillation. Nonetheless, it is mandatory to record side effects and individual adherence to DOAC therapy. Components and procedures. In this single-centre encounter, patients with non-valvular atrial fibrillation were prospectively observed soon after switching from a vitamin K antagonist to dabigatran or rivaroxaban. The efficacy, security, and tolerability in the novel treatment, and adherence to it, have been evaluated more than a period of 1 year. Clinical information were integrated with records of haemorrhagic and non-haemorrhagic complications. Each of the subjects have been given an anonymous self-report questionnaire on the degree of their adherence/satisfaction together with the remedy. Results. Of 196 sufferers with non-valvular atrial fibrillation (median age, 78.5 years) who switched from a vitamin K antagonist to DOAC, 178 completed the 1-year comply with up, of whom 87 had been provided dabigatran and 91 rivaroxaban. The efficacy in the two DOAC was comparable. Patients provided dabigatran had a higher frequency (n=32) of non-haemorrhagic complications (OR: 3.three; 95 CI: 1.7-7.8), which occurred earlier (HR: 6.1; 95 CI: 3.0-12.6) than these (n=7) recorded in subjects on rivaroxaban. The degree of satisfaction with therapy was larger among individuals on rivaroxaban (imply score 9.1, SD 1.0) than among these on dabigatran (mean score eight.7; SD 0.9; p=0.01). Discussion. Overall, in this experience, DOAC were shown to become efficient, safe options to vitamin K antagonists. Nevertheless, compared with rivaroxaban, dabigatran resulted inside a greater price and earlier occurrence of non-haemorrhagic events, and also a lower satisfaction score.Se rv icompared to VKA, and be associated having a reduced incidence of big bleeding, particularly intracranial haemorrhage, as demonstrated in well-known controlled clinical trials4-7. The potential to inactivate bound serine proteases makes DOAC stronger than warfarin and heparins. Moreover, in comparison to warfarin, DOAC have a favourable risk-benefit balance for stopping stroke and systemic arterial thromboembolism. Caution is encouraged with prescribing dabigatran to elderly sufferers since this DOAC, at a dose of 150 mg twice every day, has been related with a greater risk of important bleeding. Coagulation monitoring is not essential, but patients need to be followed up periodically with the aim of detecting new well being states that could alter the expected effectiveness or security from the drugs8. The Italian Medicines Agency (Agenzia Italiana del Farmaco – AIFA) has so far licensed 3 DOAC, which happen to be LDHA Protein medchemexpress commercially obtainable because 20132014: dabigatran etexilate (FABP4 Protein Molecular Weight Pradaxa [Boehringer Ingelheim,Rhein, Germany] 150/110 mg bid),ziSr lAll rights reserved – For individual use only No other use without having premissionSchiavoni M et alrivaroxaban (Xarelto [Bayer Pharma AG, Berlin, Germany] 20/15 mg od) and apixaban (Eliquis [Bristol-Myers Squibb, New York, USA] 5/2.5 mg bid). Prescription of those drugs was permitted only by some specialists, particularly cardiologists, internists, neurologists, geriatricians and haematologists. To decide eligibility for prescription of DOAC, the AIFA requires answers (yes/no) to a questionnaire collecting some private details and information on a potential patient’s well being status so that you can evalu.