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在ESRD和移植患者中使用直接口服抗凝剂

Nicholas W Lange¹, Justin Muir¹, David M Salerno¹

¹Department of Pharmacy, NewYork-Presbyterian Hospital, New York, USA.

Kidney international reports

|January 15, 2025

概括

像阿皮克萨班和里瓦罗克萨班这样的直接口服抗凝剂在病患者中需要小心使用. 在这个人群中,阿皮克萨班显示出与华法林相比的可比性和更好的安全性.

科学领域:

药理学和病学药理学和病学
抗凝固疗法抗凝固疗法
在脏功能障碍中药物安全性

背景情况:

直接口服抗凝剂 (DOAC) 越来越多地被用于抗凝症的指示.
艾皮克萨班和里瓦罗克萨班,常见的DOACs,在患有脏疾病的患者中具有药理学考虑.
功能衰竭和替代疗法 (RRT) 可能会增加对阿皮克萨班和里瓦罗克萨班的药物暴露.

研究的目的:

评估阿皮克萨班和里瓦罗克萨班在患有脏疾病的患者的安全性和疗效.
为了在血栓栓塞事件预防和出血风险方面将DOAC与华法林进行比较.
评估DOACs在末期病 (ESRD) 和移植接受者的作用.

主要方法:

对阿皮克萨班和里瓦罗克萨班在功能衰竭和RRT中的临床试验和现实世界的数据的审查.
对血栓塞栓事件对华法林的比较有效性的分析.
在病患者群体中评估与DOAC使用相关的出血风险.

主要成果:

在预防血栓栓塞事件和降低病患者出血风险方面,阿皮克萨班似乎比华法林相对有效和更安全.
在这个人群中,对利瓦罗克萨班的数据更为有限,显示出不一致的结果.
艾皮克萨班和里瓦罗克萨班都在ESRD患者和移植接受者中成功使用.

结论:

阿皮克萨班在患有脏疾病的抗凝血药患者中提供了潜在的有利的风险-益处概况.
需要进行进一步的前性试验,以澄清艾皮克萨班和里瓦罗克萨班在ESRD和移植群体的最佳使用情况.
在复杂的脏病患者群体中,DOACs代表了重要的新型抗凝剂.

关键词:

艾皮克萨班 (Apixaban) 是一种最终阶段的脏疾病.里瓦罗克萨班 (Rivaroxaban) 是一个

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