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Dabigatrán en la prevención del accidente cerebrovascular isquémico en pacientes con fibrilación auricular [Dabigatran for the prevention of ischemic stroke in patients with acute or chronic atrial fibrillation] |
Pichon Riviere A, Augustovski F, Garcia Marti S, Glujovsky D, Alcaraz A, Lopez A, Bardach A, Ciapponi A, Romano M |
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Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Pichon Riviere A, Augustovski F, Garcia Marti S, Glujovsky D, Alcaraz A, Lopez A, Bardach A, Ciapponi A, Romano M. Dabigatrán en la prevención del accidente cerebrovascular isquémico en pacientes con fibrilación auricular. [Dabigatran for the prevention of ischemic stroke in patients with acute or chronic atrial fibrillation] Buenos Aires: Institute for Clinical Effectiveness and Health Policy (IECS). Informe de Respuesta Rápida N°249. 2011 Authors' objectives The purpose of this report is to assess the evidence available on the efficacy, safety and issues related to coverage policies on the use of dabigatran for the prevention of ischemic stroke (IS) in patients with acute or chronic atrial fibrillation (AF). Authors' conclusions In the only randomized clinical trial, dabigatran 150mg bid is slightly better than warfarin in preventing IS, embolic events and vascular death and 100mg big is non inferior to warfarin, with no significant increase in major bleeding. It is worth mentioning that this was an open-label study, with just two-year follow up. The applicability of results is uncertain due to inadequate INR control in some countries. Quality of life in these patients, which is a primary reason for cost-effectiveness studies, was not assessed in the study. The use of dabigatran in patients with AF as an alternative to vitamin K antagonists (VKA) might be specially considered when: Patients receiving VKA therapy present unstable INR, when there is increased risk of drug and food interactions and in those who are warfarin-hypersensitive. In AF patients receiving VKA and who have adequate INR control, dabigatran might be an alternative, its comfort and higher cost should be taken into account. In patients at risk of increased bleeding, its use might be considered at 110mg doses bid, since it is as efficient as VKA but presents lower risk of bleeding. Indexing Status Subject indexing assigned by CRD MeSH Anticoagulants; Atrial Fibrillation; Benzimidazoless; Ischemic Attack, Transient; Stroke Language Published Spanish Country of organisation Argentina English summary An English language summary is available. Address for correspondence Institute for Clinical Effectiveness and Health Policy, Viamonte 2146 - 3 Piso, C1056ABH Ciudad de Buenos Aires, Argentina Tel: +54 11 49 66 00 82 Fax:+54 11 49 53 40 58 Email: info@iecs.org.ar AccessionNumber 32014000316 Date abstract record published 05/02/2014 |
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