当前位置： SCI文献检索 > JOURNAL OF THROMBOSIS AND THROMBOLYSIS期刊下所有文献 > Interacting medication use and the treatment effects of apixaban versus warfarin: results from the ARISTOTLE Trial.

Interacting medication use and the treatment effects of apixaban versus warfarin: results from the ARISTOTLE Trial.

Abstract：

:Warfarin is dependent on multiple hepatic enzymes for metabolism while apixaban is a substrate for P-glycoprotein (P-gp) transport and hepatic CYP3A4 metabolism. The aim of this analysis was to assess the impact of interacting medication use on the treatment effects of apixaban versus warfarin. Outcomes were compared between apixaban and warfarin using Cox proportional hazards modeling according to the use of interacting medications at randomization in ARISTOTLE (n = 18,201). Interacting medications for apixaban were identified as combined P-gp and 3A4 inhibitors or inducers while interacting medications for warfarin were defined as those highly probable for warfarin potentiation or inhibition. At randomization, 5547 (30.5%) patients were on an interacting medication, including 2722 on apixaban and 2825 on warfarin. Patients using an interacting medication were more likely to be female, taking aspirin, and have a history of prior bleeding and were less likely to have a prior stroke or transient ischemic attack. No significant differences were observed on the treatment effect of apixaban compared with warfarin in patients on and off interacting medications for outcomes including the primary efficacy outcome of stroke or systemic embolism (P for interaction = 0.79) or the primary safety outcome of major bleeding (P for interaction = 0.75). Use of interacting medications with anticoagulants occurs often in patients with atrial fibrillation. Despite the potential for altered exposure, interacting medication use was not associated with a significant change in the efficacy or safety of apixaban compared with warfarin in the ARISTOTLE trial.Trial registration ClinicalTrials.gov, NCT00412984.

journal_name

J Thromb Thrombolysis

journal_title

Journal of thrombosis and thrombolysis

authors

Washam JB,Hohnloser SH,Lopes RD,Wojdyla DM,Vinereanu D,Alexander JH,Gersh BJ,Hanna M,Horowitz J,Hylek EM,Xavier D,Verheugt FWA,Wallentin L,Granger CB,ARISTOTLE Committees and Investigators.

doi

10.1007/s11239-019-01823-y

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

345-352

issue

eissn

0929-5305

issn

1573-742X

pii

10.1007/s11239-019-01823-y

journal_volume

pub_type

杂志文章,随机对照试验

在线工具

Interacting medication use and the treatment effects of apixaban versus warfarin: results from the ARISTOTLE Trial.