直接口服抗凝剂和同时使用的抗发作药物:在现实世界中进行的一项回顾性病例对照研究
Eugenia Rota1, Paolo Immovilli2, Irene Pappalardo3
1The Neurology Unit, San Giacomo Hospital, ASL Alessandria, Novi Ligure, Italy.
Clinical therapeutics
|July 7, 2024
概括
直接口服抗凝剂 (DOACs) 与抗发作药物 (ASM) 结合使用,如酸 (VPA) 或 levetiracetam (LEV),在实际使用中没有增加出血或凝血事件的风险. 接受DOAC和ASM治疗的患者的结局与仅服用DOAC患者的结局相似.
科学领域:
- 药理学 药理学是指药理学的学科.
- 神经学 神经学
- 临床医学 临床医学
背景情况:
- 直接口服抗凝剂 (DOAC) 越来越多地被处方给服用抗发作药物 (ASM) 的患者.
- 由于潜在的药物相互作用,指南建议谨慎使用,但临床证据有限.
- 关于DOAC-ASM联合治疗的安全性和有效性的现实数据很少.
研究的目的:
- 评估使用DOAC-ASM联合治疗的患者中缺血/出血事件和发作的频率.
- 为了比较DOAC-ASM联合治疗与DOAC单一治疗和ASM单一治疗的结果.
- 评估DOAC和ASM之间的潜在药物相互作用的临床相关性.
主要方法:
- 一个追溯的病例控制研究设计.
- 包括124名同时接受DOAC和ASM (酸或 levetiracetam) 治疗的患者至少6个月.
- 与年龄和性别匹配的DOAC控制组和ASM控制组进行比较,使用电子健康记录数据.
主要成果:
- 在DOAC-ASM联合治疗组中,有1.6%的缺血和1.6%的主要出血事件.
- 在DOAC对照组中,3.2%的缺血事件发生,没有出血事件.
- 在联合治疗和DOAC控制组之间的缺血/出血事件中没有发现统计学上显著的差异,也没有发现与ASM控制组相比,复发率的差异.
结论:
- 同时使用 levetiracetam 或酸与DOACs 并没有显著增加在现实世界的临床环境中不良事件的风险.
- 研究结果表明,DOACs可以安全地与这些特定的ASM联合使用.
- 需要使用更大的样本大小进行进一步的研究来证实这些结果.
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