根据剂量方案对直接口服抗凝剂的坚持和持续性:系统性审查
Raúl Quirós López1, Francesc Formiga Pérez2,3, Jan Beyer-Westendorf4
1Network for Research in Chronicity, Primary Care, and Health Prevention and Promotion, Costa del Sol University Hospital, Marbella, Spain.
British journal of clinical pharmacology
|February 17, 2025
概括
每天服用一次直接口服抗凝剂 (DOACs) 与每天两次治疗非膜动 (NVAF) 的治疗方案相比,显著改善了患者的坚持和持续性. 这种剂量策略对于预防NVAF患者的栓塞事件至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
- 基于证据的实践.
背景情况:
- 直接口服抗凝剂 (DOAC) 对于预防非膜动 (NVAF) 患者的栓塞事件至关重要.
- 对DOAC治疗的低于最佳的坚持增加了严重并发症的风险.
- 了解剂量频率对坚持的影响对于有效的NVAF管理至关重要.
研究的目的:
- 为了在NVAF患者中比较授权DOAC的每日一次 (OD) 和每天两次 (BID) 剂量方案之间的坚持和持久率.
- 为优化关于DOAC剂量策略的临床决策提供基于证据的见解.
主要方法:
- 对来自PubMed,Scopus和Cochrane图书馆的文献数据进行了系统的审查.
- 包含的研究提供了量化数据,比较了OD与BID DOAC疗法在NVAF的坚持和持久性.
- 分析包括总体结果,限制结果以尽量减少偏差,以及基于随访持续时间和DOAC分子的单变量分析.
主要成果:
- 对39项涉及976,494名患者的研究的分析显示,OD治疗方案的坚持和持续性显著更高 (P < .05).
- 在53.1%的结果中,OD剂量有利于对结果的坚持,而BID则为12.2%;持久性在67.7%的结果中有利于OD,而BID则为14.9%.
- 这些发现随着时间的推移而保持一致,尽管在不同的DOAC分子中注意到了变化.
结论:
- 与每天两次治疗方案相比,每天一次的DOACs剂量在患有非膜性心房的患者中显示出更高的坚持性和持续性.
- OD疗法与更好的治疗遵从性有关,可能降低NVAF患者并发症的风险.
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