Comparing Apixaban And Enoxaparin Proliferation

Improved Essays
Lassen et al. (2009) aimed to demonstrate that Apixaban at a dose of 2.5mg twice daily is just as safe and effective as enoxaparin when administered at a dose of 30mg subcutaneously every 12 hours. While Lassen et al. (2010a) observed Apixaban at the same dose but against enoxaparin 40mg once daily. The treatment period for both studies lasted between 10-14 days. The primary efficacy outcome for the above mentioned studies included the following scenarios; symptomatic or non-symptomatic DVT, pulmonary embolisms that do not result in death and all-cause mortality. It transpired in 8.8% of patients receiving enoxaparin with a mere 0.2% increased rate of occurrence with those receiving Apixaban in the ADVANCE-1 trial. Regardless of the similar …show more content…
Furthermore when NICE were reviewing the evidence the results of this study were considered less significant as the standard mainstay of treatment in a UK clinical setting is a low molecular weight heparin (LWMH) subcutaneous enoxaparin at the a dose of 40mg (NICE 2013). Conversely the results from ADVANCE-2 were weighed. They indicated that Apixaban significantly reduces the manifestation of total VTE and all-cause mortality by 9.3% against the comparator. Similar favourable results for Apixaban over enoxaparin were documented in ADVANCE-3. The incidence of total VTE was 1.4% for Apixaban showing superior efficacy over enoxaparin where the total incidence of VTE was 3.9% (Lassen et al. 2010b). The principal differences between ADVANCE-3 and ADVANCE 1 and 2 was a longer treatment period of 35 days was employed, patients were enduring THR and enoxaparin was administered as 40mg four times a day. All three studies again support a good safety profile for Apixaban as major or clinically relevant bleeding events were consistently lower than the comparator …show more content…
2014). This poses extreme risks to patients suffering from serious bleeds. However it has driven a lot of interest in developing an antidote and currently “Andexanet alfa” is entering into phase III trials after promising results achieved in phase II trials (Portola Pharmaceuticals 2015). NICE guidance although content with the available evidence recommends further clarification of certain aspects of the studies. For instance there is limited evidence comparing Apixaban directly with other low molecular weight heparins or the new oral anticoagulants (NICE 2012). These would prove to strengthen any concerns surrounding cost effectiveness or ambiguity of the trials. To summarise Apixaban has gone through the lengthy drug discovery process and has proven to be successful providing an attractive treatment option for the aforementioned conditions according to both NICE guidance and a Cochrane review (Bruins Slot and Berge

Related Documents

  • Improved Essays

    Abilify Research Papers

    • 724 Words
    • 3 Pages

    The starting daily dose of tablet formulation in this patients was 2 mg, which is titrated to 5mg after 2 days and to be the target dose of 10mg. abilify can be administered without regards to meal. Bipolar 1 disorder: Acute treatment of maniac and mixed episodes Adults: the starting dose in adults is 15mg given once daily and 10-15mg once In daily with valproate. Abilify can be given with regards to meals. Pediatrics: the starting dose in pediatric patients (10-17yrs) as is 2mg /day after 2 additional days.…

    • 724 Words
    • 3 Pages
    Improved Essays
  • Great Essays

    Lung Cancer Case Study

    • 1637 Words
    • 7 Pages

    Between July 18, 2001 and August 19, 2002, the starting dose assigned to the 539 people on erlotinib was 150 mg. The median survival was 10.6 months in the erlotinib arm compared to 10.5 months in the placebo arm. When the researchers looked at race, age, sex and cancer stage there was no significant survival difference. When they looked at those who smoked versus those who did not smoke, those who had never smoked in the placebo arm had a 22.5 month survival on the erlotinib arm compared to the 10.1 month survival of those who have smoked. In the erlotinib arm, those who had smoke had an 8.4 month survival compared to the placebo arm’s 9.1 month survival.…

    • 1637 Words
    • 7 Pages
    Great Essays
  • Improved Essays

    A score of 0 still means there is risk of stroke but it is not very high; however, an antiplatelet agent, such as 81mg daily dose aspirin, is still recommended. At a score of 1 then antiplatelet or anticoagulation medication should be used and above 2 then anticoagulation should be used. (Ref 2) Hart et al.2 performed a meta-analysis comparing the efficacy of warfarin versus aspirin versus control with a number needed to treat (NNT) endpoint of treating for 1 year to prevent 1 stroke compared to untreated atrial fibrillation patients without previous stroke or transient ischaemic attack. The results of the study were that aspirin versus control has a relative risk reduction of 19 percent (NNT=140), adjusted-dose warfarin versus aspirin has a relative risk reduction of 39 percent (NNT=90) and adjusted-dose warfarin versus control has a relative risk reduction of 64 percent (NNT=40). For the adjusted-dose warfarin versus aspirin arm, it was an analysis of 12 trials of 12,963 patients, found through the Cochrane Stroke Group search…

    • 999 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    The daily requirements of NSAIDs was also reduced. Thus, omega-3 fatty acids reduce the inflammatory response and improve the clinical manifestations of JIA (Gheita, Kamel, Helmy, El-Laithy, & Monir, 2012). Rajaei et al. (2016) recruited 60 patients with active RA (49 females and 11 males) to investigate the effects of omega-3 on disease activity, remission of RA and reliance on analgesic drugs. Subjects participated in a 12-week, double blind, randomized placebo-controlled study and were followed every 4 weeks for three months to assess clinical and laboratory findings such as ESR, CRP, consumption of analgesic drugs, and duration of morning stiffness and pain.…

    • 1122 Words
    • 5 Pages
    Improved Essays
  • Improved Essays

    In case of NIIT operating margin in 2010 was 46.93, it kept declining and in 2013 it came 19.63. On the other hand operating margin of 3i Infotech in 2010 was 51.73 and in 2013 it came to 21.49. In case of efficiency NIIT had a better performance than 3i Infotech, but in terms of profitability 3i Infotech is better than NIIT. • In table 5 the gross profit margin has been calculated. Here in case of NIIT, the gross profit margin in year 2010 was 38.26 and it kept declining and became 16.55 in 2013.…

    • 1545 Words
    • 7 Pages
    Improved Essays
  • Superior Essays

    In the end, the placebo effect is an interesting psychological concept that has proven to be both effective and hazardous. Despite the disagreements related to specificity in psychotherapy, the results of clinical trials in psychotherapy and medicine indicate that the placebo is indeed powerful in situations where it would be expected to operate. It is clear that the beneficial aspects produced by medicine and psychotherapy involve factors that are not central to respective modal models or the received view of these endeavors. Research aimed at elucidating the placebo effect promises to produce valuable knowledge concerning the psychological and neurobiological dimensions of healing. The power of the mind continues to fascinate scientist and will continue for years to…

    • 1849 Words
    • 8 Pages
    Superior Essays
  • Improved Essays

    Likewise, the SUCCESS trial reported a significantly higher 16 weeks’ steroid-free clinical remission rate for the combination therapy compared to IFX alone, for moderate-to-severe active ulcerative colitis[28]. The post hoc analysis of the ACT 1 and 2 trials reported that 6 and 12 month remission rates are not affected by combination therapy[29]. However, a new prospective cohort study from Armuzzi et al. reported that combined IFX-AZA treatment was a predictor of steroid-free clinical remission at 6-12 months [30]. Whether all patients with UC, regardless of their prior IS status, should benefit from combination therapy remains…

    • 973 Words
    • 4 Pages
    Improved Essays
  • Superior Essays

    A randomized, double-blind study of eighteen patients with treatment-resistant bipolar depression, Diazgrenados et al. (2010) treated these patients with an IV infusion of ketamine or saline two separate days, two weeks apart. He found that within forty minutes of administration, depressive symptoms were significantly improved for ketamine compared to saline, and that these improvements lasted through the third day, but began to die down around day ten. This study suggest that the advantageous effects of ketamine were effective in these TRD patients, however the effect was not sustained over a significant amount of time, but was more significant than traditional…

    • 1073 Words
    • 4 Pages
    Superior Essays
  • Superior Essays

    Although the response rates were higher in all 3 treatment groups compared to the placebo treatment group, the differences were not statistically significantly for any pregabalin dosage (table ). FIQ pain scores for all three pregabalin treatment groups were numerically but not significantly greater than the placebo treatment group (table 1). Two randomized controlled trials by Sañudo et al, (2010-2011) showed significant improvements in health status in patients assigned to the exercise group over the control group. Significant improvements were seen in FIQ pain score after the 24-week intervention…

    • 1331 Words
    • 6 Pages
    Superior Essays
  • Superior Essays

    NTG Case Study Essay

    • 1409 Words
    • 6 Pages

    (Song & Caprioli, 2014). Several prostaglandin analogues like travoprost 0.004% (Naito et al., 2016) and tafluprost 0.0015% (Keating, 2016) showed effective and sustained reduction of IOP. Combination of prostaglandin analogs with timolol also showed greater reduction of IOP than prostaglandin monotherapy. (Igarashi et al., 2014). However, a study conducted on 4 prostaglandin analogues: latanoprost, travoprost, tafluprost, and bimatoprost, showed that up to 15% of NTG patients receiving prostaglandin analogues were non-responders.…

    • 1409 Words
    • 6 Pages
    Superior Essays