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1.
《Reumatología clinica》2019,15(5):e33-e35
Antiphospholipid syndrome is characterized by abortions or thrombotic phenomena associated with specific antibodies. Anticoagulant therapy is based on vitamin K antagonists. We present two cases in which the use of rivaroxaban achieved control of the disease after the failure of acenocoumarol.  相似文献   
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Background

We sought to evaluate the real-world effectiveness and safety of prolonged anticoagulation with rivaroxaban following a provoked venous thromboembolism.

Methods

Using US MarketScan claims from November 2012 to March 2017, we identified adults with ≥1 primary hospitalization or emergency department diagnosis code for venous thromboembolism, a provoking (major or minor, persistent or transient) risk factor, at least 3 months of continuous rivaroxaban treatment, and ≥12 months of continuous insurance benefits prior to their qualifying venous thromboembolism. Patients were categorized as either continuing rivaroxaban or discontinuing anticoagulation (no anticoagulation or nonaspirin antiplatelet agents but may have received aspirin) after the initial 3 months of rivaroxaban treatment (index date). Differences in baseline covariates between cohorts were adjusted for using inverse probability-of-treatment weights based on propensity scores (absolute standardized differences <0.1 achieved for all covariates after adjustment). Twelve month incidences of recurrent venous thromboembolism or major bleeding were compared between cohorts using Cox regression (according to an intention-to-treat methodology) and reported as hazard ratios (HRs) with 95% confidence intervals (CIs).

Results

Among patients experiencing a provoked venous thromboembolism and treated with rivaroxaban for the first 3 months (N=4,990), continued rivaroxaban use beyond 3 months (median [25%, 75% range duration of additional rivaroxaban use?=?3 [2, 5] months) was associated with a 44% (95% CI of 9%-66%) lower hazard of recurrent venous thromboembolism without altering major bleeding risk [HR of 0.87, 95% CI of 0.51-1.49] versus anticoagulation discontinuation (with or without aspirin use).

Conclusions

Our study suggests continuing rivaroxaban after the initial 3 month period was associated with a decreased risk of recurrent venous thromboembolism. The observed reduction in recurrent venous thromboembolism with prolonged rivaroxaban use was not associated with a significant change in major bleeding risk.  相似文献   
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钟益玮  胡翔  陆阳 《安徽医药》2015,(2):225-229
目的:制备利伐沙班片剂,优选适合中试生产的最佳处方。方法通过设计不同处方,对增溶剂、崩解剂、黏合剂、填充剂的用量及工艺进行考察,并进行了中试三批放大,测定在四种溶出介质中的溶出曲线、含量均匀度和有关物质等指标。结果用利伐沙班为主药,以乳糖、微晶纤维素为填充剂,以十二烷基硫酸钠为增溶剂,以交联羧甲基纤维素钠为崩解剂,以羟丙基甲基纤维素为黏合剂、以硬脂酸镁为润滑剂,以胃溶型薄膜包衣预混剂为包衣材料,制得利伐沙班片。结论该制剂工艺稳定,制得利伐沙班片(10 mg)与原研市售品溶出行为相似,质量符合规定。  相似文献   
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Introduction and objectives

To assess the effectiveness of direct oral anticoagulants vs vitamin K antagonists in real-life patients with atrial fibrillation.

Methods

A systematic review was performed according to Cochrane methodological standards. The results were reported according to the PRISMA statement. The ROBINS-I tool was used to assess risk of bias.

Results

A total of 27 different studies publishing data in 30 publications were included. In the studies with a follow-up up to 1 year, apixaban (HR, 0.93; 95%CI, 0.71-1.20) and dabigatran (HR, 0.95; 95%CI, 0.80-1.13) did not significantly reduce the risk of ischemic stroke vs warfarin, whereas rivaroxaban significantly reduced this risk (HR, 0.83; 95%CI, 0.73-0.94). Apixaban (HR, 0.66; 95%CI, 0.55-0.80) and dabigatran (HR, 0.83; 95%CI, 0.70-0.97) significantly reduced the major bleeding risk vs warfarin, but not rivaroxaban (HR, 1.02; 95%CI, 0.95-1.10), although with a high statistical heterogeneity among studies. Apixaban (HR, 0.56; 95%CI, 0.42-0.73), dabigatran (HR, 0.45; 95%CI, 0.39-0.51), and rivaroxaban (HR, 0.66; 95%CI, 0.49-0.88) significantly reduced the risk of intracranial bleeding vs warfarin. Reduced doses of direct oral anticoagulants were associated with a slightly better safety profile, but with a marked reduction in stroke prevention effectiveness.

Conclusions

Data from this meta-analysis suggest that, vs warfarin, the stroke prevention effectiveness and bleeding risk of direct oral anticoagulants may differ in real-life patients with atrial fibrillation.  相似文献   
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目的:建立利伐沙班原料药中金属催化剂镍残留的两种测定方法,并对不同方法进行比较分析。方法:方法一采用石墨炉原子吸收分光光度法;方法二采用电感耦合等离子体质谱法。结果:方法一在10~100 μg·L-1范围内线性良好,最低检出浓度为1.9 μg·L-1,方法检测限为0.2 μg·g-1,加标回收率平均为112%;方法二在0.5~20 μg·L-1范围内线性良好,最低检出浓度为0.056 μg·L-1,方法检测限为0.007 μg·g-1,加标回收率平均为97.9%。结论:6批样品的检验结果表明,两种方法对结果的测量无明显差异,但电感耦合等离子体质谱法具有分析速度快、检测限更低、灵敏度高以及可多种元素同时测定等优点,在重金属痕量分析检测方面更具优势。  相似文献   
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