PMID- 26869771
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160212
LR  - 20200930
IS  - 1177-889X (Print)
IS  - 1177-889X (Electronic)
IS  - 1177-889X (Linking)
VI  - 10
DP  - 2016
TI  - Reducing the risk of venous thromboembolism using apixaban - patient perspectives 
      and considerations. Should more attention be given to females?
PG  - 73-80
LID - 10.2147/PPA.S82484 [doi]
AB  - BACKGROUND: New oral anticoagulant agents, such as apixaban, rivaroxaban, 
      dabigatran, or endoxaban, have recently become for patients an alternative option 
      to conventional treatment in the therapy of venous thromboembolism (VTE). Thus, 
      we aimed to review the available information on adverse events (AEs) of apixaban 
      compared to conventional therapy (heparin or vitamin K antagonists) in randomized 
      controlled trials (RCTs) on patients treated for VTE, with a particular attention 
      to sex subgroups. METHODS: An electronic search in MEDLINE and Embase was 
      performed by using the keywords "apixaban" and "venous thromboembolism". All RCTs 
      focused on apixaban in the treatment and prevention of VTE were evaluated for the 
      presence of AEs. AEs were classified as serious, bleeding, and cause of 
      discontinuation. Moreover, we also searched by using the keywords "gender" and 
      "venous thromboembolism" and "anticoagulants". RESULTS: Considering all subjects 
      enrolled in the eleven RCTs as a whole to investigate the occurrence of AEs, we 
      extrapolated an events/subjects rate of 57.8% for AEs (6,445/11,144), 7.7% for 
      serious AEs (975/12,647), 9.1% for bleeding events (1,229/13,454), and 3.2% for 
      discontinuation of apixaban (421/13,039). The percentage of AEs was lower in 
      subjects treated with apixaban than in those treated with conventional VTE 
      therapy (53% vs 56.3%, respectively). However, only one study provided data on 
      separate analysis by sex of either efficacy or safety of apixaban. CONCLUSION: 
      Under the patient's perspective, apixaban could represent a good choice in the 
      treatment of VTE, due to its pharmacological, economical, and safety profile. 
      These positive aspects are certainly present in both sexes, since the available 
      studies include a correct percentage of women, but data with separate analyses by 
      sex are extremely limited. Future clinical trials should include in their results 
      on clinical impact and outcomes a stratification by sex, and studies aimed to 
      evaluate possible sex-related differences for these drugs should be strongly 
      encouraged.
FAU - Fabbian, Fabio
AU  - Fabbian F
AD  - School of Medicine, University of Ferrara, Ferrara, Italy.
FAU - De Giorgi, Alfredo
AU  - De Giorgi A
AD  - School of Medicine, University of Ferrara, Ferrara, Italy.
FAU - Tiseo, Ruana
AU  - Tiseo R
AD  - School of Medicine, University of Ferrara, Ferrara, Italy.
FAU - Zucchi, Beatrice
AU  - Zucchi B
AD  - School of Medicine, University of Ferrara, Ferrara, Italy.
FAU - Manfredini, Roberto
AU  - Manfredini R
AD  - School of Medicine, University of Ferrara, Ferrara, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20160127
PL  - New Zealand
TA  - Patient Prefer Adherence
JT  - Patient preference and adherence
JID - 101475748
PMC - PMC4734816
OTO - NOTNLM
OT  - adverse events
OT  - apixaban
OT  - deep vein thrombosis
OT  - sex
OT  - venous thromboembolism
EDAT- 2016/02/13 06:00
MHDA- 2016/02/13 06:01
PMCR- 2016/01/27
CRDT- 2016/02/13 06:00
PHST- 2016/02/13 06:00 [entrez]
PHST- 2016/02/13 06:00 [pubmed]
PHST- 2016/02/13 06:01 [medline]
PHST- 2016/01/27 00:00 [pmc-release]
AID - ppa-10-073 [pii]
AID - 10.2147/PPA.S82484 [doi]
PST - epublish
SO  - Patient Prefer Adherence. 2016 Jan 27;10:73-80. doi: 10.2147/PPA.S82484. 
      eCollection 2016.