Severe Bleeding Risks of Direct Oral Anticoagulants in the Prevention and Treatment of Venous Thromboembolism: A Network Meta-Analysis of Randomised Controlled Trials

Chen, J.; Lv, M.; Wu, S.; Jiang, S.; Xu, Wenzhi; Qian, J.; Chen, Mingrong; Fang, Zuxiang; Zeng, Z.; Zhang, Jinhua

doi:10.1016/j.jvs.2022.02.015

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“…The incidence rate of major bleeding was 17.2% of the hemorrhage events and the most common site of major bleeding was the gastrointestinal system (2.07%). Because of the strong concealment of gastrointestinal bleeding, a high mortality rate and substantial healthcare costs were incurred (Chen et al., 2021; Cheung & Leung, 2017; Holster et al., 2013).…”

Section: Introductionmentioning

confidence: 99%

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Effect of ABCB1 gene variants on rivaroxaban pharmacokinetic and hemorrhage events occurring in patients with non‐valvular atrial fibrillation

Zhang

Qin

et al. 2022

Biopharm & Drug Disp

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Hemorrhage events occur most frequently in anticoagulant therapy for non-valvular atrial fibrillation (NVAF). Rivaroxaban is used widely for routine anticoagulation care. Genetic polymorphisms are thought to contribute to the wide intraindividual variability seen in rivaroxaban metabolism and the anticoagulant response. The aim of this study was to evaluate the effect of drug transport related single-nucleotide polymorphisms (SNPs) on rivaroxaban metabolism and on the risk of a hemorrhage event. A total of 216 Chinese patients with NVAF were enrolled in the study.Rivaroxaban was used for anticoagulation therapy. Rivaroxaban plasma concentrations were detected using a validated ultra-performance liquid chromatographytandem mass spectrometry (UPLC-MS/MS) method. Seven SNPs in four genes were genotyped using the Sanger dideoxy DNA sequencing method. Associations between genotype variants, the incidence of hemorrhage events, and the time of bleeding were analyzed. ABCB1 2677G (rs2032582) variation was highly associated with the dose-adjusted rivaroxaban peak concentration in plasma (C max /D) (p = 0.025, FDR = 0.042). The ABCB1 G allele carriers had a higher rivaroxaban C max /D than non-carriers. Logistic regression showed that rivaroxaban C max /D and ABCB1 genotype variants were associated with a higher incidence of hemorrhage events. No statistically significant difference was found between ABCB1 genotypes and the time of bleeding after anticoagulant therapy in 30 days. These results indicated that ABCB1 2677G (rs2032582) genetic variant affects the rivaroxaban C max /Dose and the incidence of hemorrhage events significantly.

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Section: Introductionmentioning

confidence: 99%

“…Because of the strong concealment of gastrointestinal bleeding, a high mortality rate and substantial healthcare costs were incurred (Chen et al, 2021;Cheung & Leung, 2017;Holster et al, 2013).…”

mentioning

confidence: 99%

Effect of ABCB1 gene variants on rivaroxaban pharmacokinetic and hemorrhage events occurring in patients with non‐valvular atrial fibrillation

Zhang

Qin

et al. 2022

Biopharm & Drug Disp

View full text Add to dashboard Cite

show abstract

Severe Bleeding Risks of Direct Oral Anticoagulants in the Prevention and Treatment of Venous Thromboembolism: A Network Meta-Analysis of Randomised Controlled Trials

Cited by 1 publication

References 0 publications

Effect of ABCB1 gene variants on rivaroxaban pharmacokinetic and hemorrhage events occurring in patients with non‐valvular atrial fibrillation

Effect of ABCB1 gene variants on rivaroxaban pharmacokinetic and hemorrhage events occurring in patients with non‐valvular atrial fibrillation

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