PMID- 31314619
OWN - NLM
STAT- MEDLINE
DCOM- 20200220
LR  - 20200220
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 22
IP  - 10
DP  - 2019 Oct
TI  - Effectiveness and safety of betrixaban extended prophylaxis for venous 
      thromboembolism compared with standard-duration prophylaxis intervention in acute 
      medically ill patients: a systematic literature review and network meta-analysis.
PG  - 1063-1072
LID - 10.1080/13696998.2019.1645679 [doi]
AB  - Aims: To determine the clinical effectiveness and safety of venous 
      thromboembolism (VTE) prophylaxis using US- and Europe-approved anticoagulants 
      relative to extended-duration VTE prophylaxis with betrixaban. Low molecular 
      weight heparins (LMWHs), unfractionated heparin (UFH), fondaparinux sodium and 
      placebo were each compared to betrixaban, as standard-duration VTE prophylaxis 
      for hospitalized, non-surgical patients with acute medical illness at risk of 
      VTE. Materials and methods: A systematic literature review was conducted up to 
      June 2019 to identify randomized controlled trials (RCTs) of VTE prophylaxis in 
      hospitalized, non-surgical patients with acute medical illness at risk of VTE. 
      Studies that reported the occurrence of VTE events (including death) and, where 
      possible, major bleeding, from treatment initiation to 20-50 days thereafter were 
      retrieved and extracted. A Bayesian fixed effect network meta-analysis was used 
      to estimate efficacy and safety of betrixaban compared with standard-duration VTE 
      prophylaxis. Results: Seven RCTs were analyzed which compared betrixaban, LMWHs, 
      UFH, fondaparinux sodium, or placebo. There were significantly higher odds 
      (median odds [95% credible interval]) of VTE with LMWHs (1.38 [1.12-1.70]), UFH 
      (1.60 [1.05-2.46]), and placebo (2.37 [1.55-3.66]) compared with betrixaban. 
      There were significantly higher odds of VTE-related death with placebo (7.76 
      [2.14-34.40]) compared with betrixaban. No significant differences were observed 
      for the odds of major bleeding with all comparators, VTE-related death with any 
      active standard-duration VTE prophylaxis, or of VTE with fondaparinux sodium, 
      compared with betrixaban. Limitations and conclusions: In this indirect 
      comparison, betrixaban was shown to be an effective regimen with relative 
      benefits compared with LMWHs and UFH. This indicates that betrixaban could reduce 
      the burden of VTE in at-risk hospitalized patients with acute medical illness who 
      need extended prophylaxis, though without direct comparative evidence, stronger 
      conclusions cannot be drawn.
FAU - Laskier, Vicki
AU  - Laskier V
AD  - Health Economics, FIECON Ltd , St Albans , UK.
FAU - Guy, Holly
AU  - Guy H
AD  - Health Economics, FIECON Ltd , St Albans , UK.
FAU - Fisher, Mark
AU  - Fisher M
AD  - Health Economics, FIECON Ltd , St Albans , UK.
FAU - Neuman, W Richey
AU  - Neuman WR
AD  - Medical Affairs, Portola Pharmaceuticals, Inc , South San Francisco , CA , USA.
FAU - Bucior, Iwona
AU  - Bucior I
AD  - Medical Affairs, Portola Pharmaceuticals, Inc , South San Francisco , CA , USA.
FAU - Cohen, Alexander T
AU  - Cohen AT
AD  - Department of Haematological Medicine, Guy's and St. Thomas' Hospitals, King's 
      College London , London , UK.
FAU - Ren, Shijie
AU  - Ren S
AD  - HEDS, ScHARR, The University of Sheffield , Sheffield , UK.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20190809
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
RN  - 0 (Anticoagulants)
RN  - 0 (Benzamides)
RN  - 0 (Delayed-Action Preparations)
RN  - 0 (Factor Xa Inhibitors)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Pyridines)
RN  - 74RWP7W0J9 (betrixaban)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Acute Disease
MH  - Anticoagulants/therapeutic use
MH  - Bayes Theorem
MH  - Benzamides/*therapeutic use
MH  - Delayed-Action Preparations/*therapeutic use
MH  - Factor Xa Inhibitors/*therapeutic use
MH  - Heparin/therapeutic use
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Humans
MH  - Network Meta-Analysis
MH  - *Patient Safety
MH  - Pyridines/*therapeutic use
MH  - Treatment Outcome
MH  - Venous Thromboembolism/*drug therapy/*prevention & control
OTO - NOTNLM
OT  - C10
OT  - C11
OT  - Venous thromboembolism
OT  - betrixaban
OT  - network meta-analysis
OT  - pre-exposure thromboprophylaxis
OT  - primary thromboprophylaxis
EDAT- 2019/07/18 06:00
MHDA- 2020/02/23 06:00
CRDT- 2019/07/18 06:00
PHST- 2019/07/18 06:00 [pubmed]
PHST- 2020/02/23 06:00 [medline]
PHST- 2019/07/18 06:00 [entrez]
AID - 10.1080/13696998.2019.1645679 [doi]
PST - ppublish
SO  - J Med Econ. 2019 Oct;22(10):1063-1072. doi: 10.1080/13696998.2019.1645679. Epub 
      2019 Aug 9.