Most Read Articles
Rachel Soon, 26 Jun 2018

MIMS Pharmacist presents an overview of phosphatidylcholine's physiological role, as well as contemporary research on its pharmacology and effects.

17 Mar 2018
Nonvitamin K antagonist oral anticoagulants (NOAC)-associated intracerebral haemorrhage (ICH) and vitamin K antagonists-ICH appear to have similar ICH volume, haematoma expansion, functional outcome and mortality, results of a recent meta-analysis have shown.
31 May 2017
New drug applications approved by US FDA as of 16 - 31 May 2017 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. Supplemental approvals may have occurred since the original approval date.
09 Dec 2017
Intravenous (IV) iron is less toxic and more effective compared to oral iron, making it a potential frontline therapy for neonatal iron deficiency anaemia, suggests a recent study.

NSAID use ups risk of major bleeding, stroke in patients with atrial fibrillation

19 Jul 2018

Nonsteroidal anti-inflammatory drugs (NSAIDs) appear to increase the risk of major bleeding, stroke or systemic embolism, and hospitalization among patients with atrial fibrillation (AF), suggest the results of the RE-LY* trial. Moreover, there is no difference in the safety and efficacy of dabigatran etexilate (DE) 150 and 110 mg twice daily relative to warfarin.

A total of 18,113 patients were included in the RE-LY study, of which 2,279 used NSAIDs at least once during the trial. NSAID users had significantly elevated major bleeding (hazard ratio [HR], 1.68; 95 percent CI, 1.40–2.02; p<0.0001). NSAID vs warfarin use did not significantly alter the risk of major bleeding for DE 150 or 110 mg twice daily (p=0.63 and p=0.93 for interaction, respectively).

NSAID use significantly elevated gastrointestinal major bleeding (HR, 1.81; 1.35–2.43; p<0.0001) and the rate of stroke or systemic embolism (HR, 1.50; 1.12–2.01; p=0.007), but it did not significantly alter the relative efficacy on stroke or systemic embolism for DE 150 or 110 mg twice daily relative to warfarin (p=0.59 and p=0.54 for interaction, respectively).

Rates of myocardial infarction were comparable between NSAID use and no NSAID use (HR, 1.22; 0.77–1.93; p=0.40). Furthermore, NSAID use resulted in frequently more hospitalizations (HR, 1.64; 1.51–1.77; p<0.0001).

The authors performed a posthoc analysis of NSAIDs in the RE-LY trial, which compared DE 150 and 110 mg twice daily with warfarin in patients with AF. Clinical outcomes were assessed using treatment-independent, multivariate-adjusted Cox regression analysis by comparing NSAID use with no NSAID use. Interaction analysis was obtained from treatment-dependent Cox regression modelling, and time-varying covariate analysis for NSAID use was applied to the Cox model.

*Randomized Evaluation of Long Term Anticoagulant Therapy

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Most Read Articles
Rachel Soon, 26 Jun 2018

MIMS Pharmacist presents an overview of phosphatidylcholine's physiological role, as well as contemporary research on its pharmacology and effects.

17 Mar 2018
Nonvitamin K antagonist oral anticoagulants (NOAC)-associated intracerebral haemorrhage (ICH) and vitamin K antagonists-ICH appear to have similar ICH volume, haematoma expansion, functional outcome and mortality, results of a recent meta-analysis have shown.
31 May 2017
New drug applications approved by US FDA as of 16 - 31 May 2017 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. Supplemental approvals may have occurred since the original approval date.
09 Dec 2017
Intravenous (IV) iron is less toxic and more effective compared to oral iron, making it a potential frontline therapy for neonatal iron deficiency anaemia, suggests a recent study.