以表型为导向的临床驱动的低剂量直接口服抗凝剂用于心房动
1Department of Internal Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan.
Future cardiology
|August 31, 2023
概括
减少直接口服抗凝剂对心房的剂量是常见的,但缺乏证据. 本综述检查了针对特定患者群体减少抗凝剂剂量的现实数据,以支持个性化处方.
科学领域:
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
- 现实世界的证据.
背景情况:
- 在全球范围内,临床驱动的直接口服抗凝剂 (DOAC) 对心房 (AF) 的剂量降低是普遍存在的.
- 目前的DOAC剂量是基于对高度精选的人群进行的里程碑式试验,缺乏对不同患者表型的证据.
- 有一个显著的临床未满足的需要基于证据的指导来定制DOAC剂量.
研究的目的:
- 审查对低剂量DOACs的疗效和安全性的现实研究.
- 为特定患者表型提供个性化DOAC处方的证据.
- 为了解决针对心房的定制抗凝药治疗的临床缺口.
主要方法:
- 对现实世界的研究进行系统审查.
- 对特定患者子组的DOAC疗效和安全数据的分析.
- 包括关于脏和肝脏疾病,老年人,低体重,亚洲人口和药物相互作用的研究.
主要成果:
- 现实世界的数据表明,在不同患者表型中,降低剂量的DOACs的疗效和安全性不同.
- 证据支持需要个性化剂量策略,超出标准建议.
- 特定的患者群体可能受益于或需要剂量调整以获得最佳结果.
结论:
- 目前普遍的DOAC剂量方法可能不适合所有心房的患者.
- 在特定的表型中,根据现实世界的证据指导的个性化DOAC处方是合理的.
- 对量身定制的抗凝剂治疗的进一步研究可以改善患者的治疗结果和安全性.
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