作为延长预防的低剂量里瓦罗克萨班减少了恶性病和IBD患者的出院后静脉血栓栓塞
James W Ogilvie1, Mariam T Khan2, Emiko Hayakawa2
1Division of Colorectal Surgery, Corewell Health, Grand Rapids, Michigan.
Diseases of the colon and rectum
|December 1, 2023
概括
使用低剂量里瓦罗克萨班的扩展预防在结肠直肠癌和IBD患者中显著减少出院后静脉血栓栓塞. 这种口服治疗显示出低出血风险,为VTE预防提供了更安全的替代方案.
科学领域:
- 药理学和治疗学 药理学和治疗学
- 胃肠道学和瘤学
- 血管外科 血管外科
背景情况:
- 准则建议在结直肠癌 (CRC) 和炎症性肠病 (IBD) 患者的静脉血栓栓塞 (VTE) 扩展预防,但口服疗法的常规使用较低.
- 关于口服延长预防在这些高风险患者群体中进行静脉瘤预防的疗效和安全性的数据有限.
研究的目的:
- 在接受低剂量里瓦洛克萨班的长期预防的患者中,比较出院后静脉血栓塞栓症 (VTE) 的发生率.
- 评估口服里瓦罗克萨班在高风险手术患者的延长静脉瘤预防中的安全性和有效性.
主要方法:
- 倾向匹配用于比较2年间的干预前后分析.
- 包括接受手术切除的结肠直肠癌和IBD患者.
- 预期队列接受了手术后30天的10毫克里瓦罗克萨班;主要结果是退院后30天的VTE发病率.
主要成果:
- 与历史对照组相比,前性里瓦洛克萨班组的术后静脉瘤发作率明显较低 (0.6%与4.8%,p=0.019).
- 里瓦洛克萨班组的大型出血的发生率为1.1%,所有病例都需要干预.
- 预期队列中的不同抗凝策略的出血率是可比的.
结论:
- 用低剂量里瓦罗克萨班进行延长预防,在IBD和结直肠癌患者中显著降低了出院后的血栓栓塞事件.
- 口服抗凝剂显示出有利的低出血风险概况.
- 研究的局限性包括单一机构的数据和没有安慰剂手臂.
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