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RE-SPECT CVT(R)研究結(jié)果公布 -- 這是首項(xiàng)將NOAC用于腦靜脈血栓的試驗(yàn)

2019-09-05 18:19 6758
勃林格殷格翰于 近日公布了Re-Spect? CVT(R)研究的初步分析結(jié)果,這是首個探索性、前瞻性、隨機(jī)對照的NOAC研究,研究對象為腦靜脈或靜脈竇中有血塊的患者。
  • 發(fā)表于JAMA Neurology的研究探索了泰畢全®(達(dá)比加群酯)用于腦靜脈和硬腦膜竇血栓(CVT)患者的情況
  • 這是該人群中首個針對非維生素K拮抗劑口服抗凝劑的探索性研究
  • 此項(xiàng)研究再次證實(shí)了勃林格殷格翰致力于推進(jìn)血栓治療的決心

德國殷格翰2019年9月5日 /美通社/ -- 勃林格殷格翰于近日公布了Re-Spect CVT®研究的初步分析結(jié)果,這是首個探索性、前瞻性、隨機(jī)對照的NOAC研究,研究對象為腦靜脈或靜脈竇中有血塊的患者。該試驗(yàn)旨在研究泰畢全®(達(dá)比加群酯)和劑量調(diào)節(jié)后的華法林在CVT患者中的安全性和療效。

此項(xiàng)研究結(jié)果為輕中度CVT患者的抗凝治療提供了依據(jù)。在研究中,兩個治療組均無復(fù)發(fā)性靜脈血栓栓塞(VTE)事件的發(fā)生。1試驗(yàn)還發(fā)現(xiàn)患者的出血率較低,華法林組有兩名患者(3.3%)、達(dá)比加群組有一名患者(1.7%)出現(xiàn)嚴(yán)重出血。在此次研究中,兩個治療組均未出現(xiàn)死亡事件。[1]

“CVT全稱為腦靜脈血栓,主要影響年輕患者和女性,可導(dǎo)致死亡和殘疾。CVT急性期存活的患者可能會出現(xiàn)復(fù)發(fā)性靜脈血栓。為了防止這類情況的發(fā)生,通常的臨床做法是給患者處方維生素K拮抗劑(VKAs,如華法林)。VKAs在安全性、劑量、可逆性和患者偏好方面均存在局限性?!逼咸蜒览锼贡臼ガ旣悂嗎t(yī)院神經(jīng)科學(xué)和心理健康科主任、RE-SPECT CVT指導(dǎo)委員會主席Jose M. Ferro教授說道。“RE-SPECT CVT是迄今為止在CVT患者中進(jìn)行的最大規(guī)模的試驗(yàn),涵蓋了120名患者。試驗(yàn)表明,在使用達(dá)比加群抗凝治療6個月后,輕至中度CVT患者的VTE復(fù)發(fā)風(fēng)險(xiǎn)較低,且發(fā)生嚴(yán)重或臨床相關(guān)出血事件的概率極低?!?/p>

該試驗(yàn)也表明了勃林格殷格翰致力于擴(kuò)展血栓治療領(lǐng)域科學(xué)知識的決心。此外,試驗(yàn)還幫助我們進(jìn)一步了解了達(dá)比加群的安全性,達(dá)比加群的安全性已記錄在廣泛的RE-VOLUTION®試驗(yàn)和登記研究項(xiàng)目中。[2]-[24]

References

[1] Ferro JM. et al. Safety and Efficacy of Dabigatran Etexilate vs Dose-Adjusted Warfarin in Patients With Cerebral Venous Thrombosis: A Randomized Clinical Trial. JAMA Neurol. Published online September 03, 2019. doi:10.1001/jamaneurol.2019.2764
[2] Connolly. SJ. et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139-51. 
[3] Connolly SJ. et al. Newly identified events in the RE-LY trial. N Engl J Med. 2010;363:1875-76.
[4] Connolly SJ et al. Additional Events in the RE-LY Trial. N Engl J Med. 2014;371:1464–5
[5] Connolly SJ et al. The Long-Term Multicenter Observational Study of Dabigatran Treatment in Patients With Atrial Fibrillation (RELY-ABLE) Study. Circulation. 2013;128:237–43
[6] Ezekowitz MD et al. Long-term evaluation of dabigatran 150 vs. 110 mg twice a day in patients with non-valvular atrial fibrillation. Europace. 2016;18:973–8
[7] Cannon CP et al. Dual Antithrombotic Therapy with Dabigatran after PCI in Atrial Fibrillation. N Engl J Med. 2017;377:1513–24
[8] Calkins H et al. Uninterrupted Dabigatran versus Warfarin for Ablation in Atrial Fibrillation. N Engl J Med. 2017;376:1627–36
[9] Pollack CV et al. Idarucizumab for Dabigatran Reversal - Full Cohort Analysis. N Engl J Med. 2017;377:431–41
[10] Pollack CV et al. Idarucizumab for Dabigatran Reversal. N Engl J Med. 2015;373:511–20
[11] Eriksson BI et al. Oral dabigatran etexilate vs. subcutaneous enoxaparin for the prevention of venous thromboembolism after total knee replacement: the RE-MODEL randomized trial. J Thomb Haemost. 2007;5:2178–85
[12] RE-MOBILIZE Writing Committee et al. Oral thrombin inhibitor dabigatran etexilate vs North American enoxaparin regimen for prevention of venous thromboembolism after knee arthroplasty surgery. J Arthroplasty. 2009;24:1–9
[13] Eriksson BI et al. Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement: a randomised, double-blind, non-inferiority trial. Lancet 2007;370:949–56
[14] Eriksson BI et al. Oral dabigatran versus enoxaparin for thromboprophylaxis after primary total hip arthroplasty (RE-NOVATE II*). A randomised, double-blind, non-inferiority trial. Thromb Haemost. 2011;105:721–9
[15] Schulman S et al. Dabigatran versus Warfarin in the Treatment of Acute Venous Thromboembolism. N Engl J Med. 2009;361:2342–52
[16] Schulman S et al. Treatment of acute venous thromboembolism with dabigatran or warfarin and pooled analysis. Circulation. 2014;129:764–72
[17] Schulman S et al. Extended Use of Dabigatran, Warfarin, or Placebo in Venous Thromboembolism. N Engl J Med. 2013;368:709–18
[18] Eikelboom JW et al. Dabigatran versus warfarin in patients with mechanical heart valves. N Engl J Med. 2013;369:1206–14
[19] Diener HC et al. Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source. N Engl J Med 2019; 380:1906-1917.
[20] Ferro JM. et al. Randomized evaluation of the safety and efficacy of dabigatran etexilate versus dose adjusted warfarin in patients with cerebral venous thrombosis (RE-SPECT CVT). Presented on Tuesday 10 May at the 2nd European Stroke Organisation Conference 2016, Barcelona, Spain.
[21] Ageno W et al. RE-COVERY DVT/PE: Rationale and design of a prospective observational study of acute venous thromboembolism with a focus on dabigatran etexilate. Thromb Haemost. 2017;117:415–21
[22] Huisman MV et al. The Changing Landscape for Stroke Prevention in AF: Findings From the GLORIA-AF Registry Phase 2. J Am Coll Cardiol. 2017;69:777–85
[23] Huisman MV et al. Design and rationale of Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation: a global registry program on long-term oral antithrombotic treatment in patients with atrial fibrillation.
Am Heart J.2014;167:329–34
[24] Fanikos J et al. RE-VECTO: Idarucizumab drug administration surveillance program results. The Congress on Open Issues in Thrombosis and Hemostasis 2018 jointly with the 9th Russian Conference on Clinical Hemostasiology and Hemorheology. Abstract;68.  

消息來源:勃林格殷格翰
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