在美国一项基于医院的观察性研究中,使用安德克萨奈特阿尔法与4因子前列红素复合缩剂降低了因子XA抑制剂相关的大型出血的死亡率
Paul P Dobesh1, Gregory J Fermann2, Mary J Christoph3
1University of Nebraska Medical Center, College of Pharmacy, Omaha, Nebraska, USA.
Research and practice in thrombosis and haemostasis
|September 27, 2023
概括
在服用XA因子抑制剂时出现严重出血的患者中,安德克萨内特阿尔法显著降低了50%的住院死亡率,相比于4因子前素复合缩物 (4F-PCC). 这一发现在内和胃肠道出血中是一致的.
科学领域:
- 药理学和治疗学 药理学和治疗学
- 临床医学 临床医学
- 血液学 血液学 血液学
背景情况:
- 在现实临床实践中,对安德克萨内特阿尔法与4因子前素复合缩物 (4F-PCC) 进行了有限的比较研究.
- 评估这些药物治疗XA因子抑制剂相关出血的患者的临床结果至关重要.
研究的目的:
- 为了比较 andexanet alfa 和 4F-PCC 之间的住院死亡率.
- 评估安德克萨内特阿尔法与4F-PCC在利瓦罗克萨班或阿皮克萨班相关重大出血的患者中的疗效.
主要方法:
- 一项观察性队列研究利用了来自美国354家医院的电子健康记录 (2018年5月-2022年9月).
- 纳入标准涉及18岁以上因抗凝血药物引起严重出血的患者,这些患者接受了安德克萨内特α或4F-PCC治疗.
- 进行了多变量和倾向分数加权的逻辑回归分析,以评估住院死亡率.
主要成果:
- 该研究包括4395名患者:2122人接受了安德克萨尼特阿尔法治疗,2273人接受了4F-PCC.
- 与4F-PCC (OR,0.50;P <.01) 相比,安德克萨内特阿尔法与住院死亡率降低50%相关.
- 这种风险降低与内出血 (OR,0.55) 和胃肠道出血 (OR,0.49) 一致.
结论:
- 与4F-PCC相比,在因XA抑制剂引起大出血的患者中,安德克萨内特阿尔法治疗与住院死亡率显著降低有关.
- 在不同类型的大型出血,包括内和胃肠道出血中,观察到的安德克萨尼特阿尔法的益处是一致的.
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