Most Read Articles
Pearl Toh, 30 Mar 2018
Diagnosis of polycystic ovary syndrome (PCOS) is challenging, and there should be no rush to label an adolescent as having the condition before a thorough evaluation of symptoms, according to a leading endocrinologist who was speaking at the RCOG World Congress 2018 in Singapore.
Rachel Soon, 12 Dec 2018

A new ‘cooling’ drink product incorporating elements of traditional Chinese medicine (TCM) was launched in Kuala Lumpur recently.

06 Feb 2019
Depression symptoms in acne patients may improve following treatment with isotretinoin, according to a systematic review and meta-analysis.
Jairia Dela Cruz, 20 Dec 2017
The third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) osimertinib affords better progression-free survival (PFS) than standard EFGR-TKIs in the first-line treatment of EGFR mutation–positive advanced nonsmall-cell lung cancer (NSCLC), with similar safety profile and lower serious adverse event rates, as reported in the phase III FLAURA trial.

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
Pearl Toh, 30 Mar 2018
Diagnosis of polycystic ovary syndrome (PCOS) is challenging, and there should be no rush to label an adolescent as having the condition before a thorough evaluation of symptoms, according to a leading endocrinologist who was speaking at the RCOG World Congress 2018 in Singapore.
Rachel Soon, 12 Dec 2018

A new ‘cooling’ drink product incorporating elements of traditional Chinese medicine (TCM) was launched in Kuala Lumpur recently.

06 Feb 2019
Depression symptoms in acne patients may improve following treatment with isotretinoin, according to a systematic review and meta-analysis.
Jairia Dela Cruz, 20 Dec 2017
The third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) osimertinib affords better progression-free survival (PFS) than standard EFGR-TKIs in the first-line treatment of EGFR mutation–positive advanced nonsmall-cell lung cancer (NSCLC), with similar safety profile and lower serious adverse event rates, as reported in the phase III FLAURA trial.