Specifically, we identified all new users of each target drug (warfarin and rivaroxaban) who satisfied the following 7 criteria of the original study: (1) had at least 183 days of nonexposure before the first target drug exposure; (2) had at least 1 atrial fibrillation or atrial flutter diagnosis code within the 183-day window prior to first exposure; (3) did not have any prior diagnosis or procedure codes indicative of long-term dialysis; (4) did not have any prior diagnosis or procedure codes indicative of kidney transplant; (5) did not have any prior diagnosis or procedure code indicative of mitral stenosis or mechanical heart valve; (6) did not have any prior procedure code indicative of joint replacement or arthroplasty surgery; and (7) did not have prior use of any anticoagulant (warfarin, rivaroxaban, dabigatran, or apixaban). For each target drug, we created 2 cohorts: new users of the drug (defined by satisfying criteria No. 1), and the subset of those new users of the drug who satisfied the remaining 6 criteria. For each cohort, we produced a standardized descriptive summary of the population, including demographics (gender and age distribution), comorbidities (prevalence of conditions in time window prior to cohort entry), concomitant medications (prevalence of drug exposure in time window prior to cohort entry), and service utilization (prevalence of procedures in time window prior to cohort entry). We measured the execution time for the standardized analytic routine when applied to each target drug across all 6 databases. Analyses were conducted on a Microsoft Server 2008 (Microsoft Corporation, Redmond, Washington) with an AMD Opteron 6172 (Advanced Micro Devices, Inc, Sunnyvale, California), 2.10 GHz, 2 processors, 24-core CPU, and 256 GB of RAM. Each CDM was stored in a separate database within an instance of Microsoft SQL Server 2012 (Microsoft Corporation, Redmond, Washington).
Apixaban
It works by blocking the activity of factor Xa, a key enzyme in the blood clotting cascade.
Apixaban has been shown to be effective in reducing the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation, and in reducing the risk of recurrent venous thromboembolism.
It is available in oral tablet form and is typically taken twice daily.
Experiance better research outcomes with PubCompare.ai's innovative tools for optimizing your Apixaban studies.
Most cited protocols related to «Apixaban»
Specifically, we identified all new users of each target drug (warfarin and rivaroxaban) who satisfied the following 7 criteria of the original study: (1) had at least 183 days of nonexposure before the first target drug exposure; (2) had at least 1 atrial fibrillation or atrial flutter diagnosis code within the 183-day window prior to first exposure; (3) did not have any prior diagnosis or procedure codes indicative of long-term dialysis; (4) did not have any prior diagnosis or procedure codes indicative of kidney transplant; (5) did not have any prior diagnosis or procedure code indicative of mitral stenosis or mechanical heart valve; (6) did not have any prior procedure code indicative of joint replacement or arthroplasty surgery; and (7) did not have prior use of any anticoagulant (warfarin, rivaroxaban, dabigatran, or apixaban). For each target drug, we created 2 cohorts: new users of the drug (defined by satisfying criteria No. 1), and the subset of those new users of the drug who satisfied the remaining 6 criteria. For each cohort, we produced a standardized descriptive summary of the population, including demographics (gender and age distribution), comorbidities (prevalence of conditions in time window prior to cohort entry), concomitant medications (prevalence of drug exposure in time window prior to cohort entry), and service utilization (prevalence of procedures in time window prior to cohort entry). We measured the execution time for the standardized analytic routine when applied to each target drug across all 6 databases. Analyses were conducted on a Microsoft Server 2008 (Microsoft Corporation, Redmond, Washington) with an AMD Opteron 6172 (Advanced Micro Devices, Inc, Sunnyvale, California), 2.10 GHz, 2 processors, 24-core CPU, and 256 GB of RAM. Each CDM was stored in a separate database within an instance of Microsoft SQL Server 2012 (Microsoft Corporation, Redmond, Washington).
Schematic representation model. ASA, aspirin CRNM, clinically relevant non-major; ICH, intracranial haemorrhages; NVAF, non-valvular atrial fibrillation; AC, anticoagulant; IS, ischaemic stroke; HS, haemorrhagic stroke. ‘M’ represents a Markov process with 11 health states that are identical for each of the treatment options. All patients remain in the ‘NVAF’ state until one of stroke, bleed, SE, MI, treatment discontinuation, or death occurs. The transition probabilities of these events depend on the treatment. For patients on second-line aspirin ‘NVAF subsequent ASA’ the events are identical however patients cannot experience any further discontinuation. Triangles indicate which health state the patient enters after an event. Health states coloured in blue are permanent health states, with the remainder being transient health states occurring for a maximum period of 6 weeks before returning to the prior or subsequent health state.
The population of interest was adults (aged ≥18 years) with NVAF receiving an oral anticoagulant. Both studies reporting on incident (i.e., beginning anticoagulant treatment) and prevalent (i.e., continuing treatment) patients were included. The interventions of interest were the Factor Xa inhibitors apixaban and rivaroxaban and the direct thrombin inhibitor dabigatran.
The following databases were searched on 1 December 2016: Medline and Embase (accessed using the Ovid platform), and the Cochrane Library (accessed via Wiley Interscience), including the Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), the Cochrane Central Register of Controlled Trials (CENTRAL), the Health Technology Assessment (HTA) database, and the NHS Economic Evaluation Database (NHS EED). No restrictions were applied in terms of publication date, language, or geographical scope. Details of the search strategy are presented in the Supplementary Material.
Two independent reviewers performed the study selection, and any differences were resolved by a third reviewer. Extracted data were those on citation characteristics, study details, patient characteristics, results, and study limitations; all extracted data were quality-checked by a second reviewer.
The outcomes of interest relating to drug efficacy were: IS, all-cause mortality, myocardial infarction (MI), venous thromboembolism (VTE), a composite of ischemic stroke or systemic embolism (IS/SE), and a composite of IS/SE/all-cause mortality. Outcomes of interest relating to drug safety were: HS, ICH, major bleeding, gastrointestinal (GI) bleeding, and any bleeding. A final outcome of interest was persistence/non-persistence, defined as a break in treatment of at least 60 days.
The following three comparisons were made: 1) rivaroxaban vs. VKAs, 2) dabigatran vs. VKAs, and 3) apixaban vs. VKAs using the inverse variance-weighted method to pool hazard ratios (HRs) and their 95% confidence intervals (CIs) in a meta-analysis. The inverse variance-weighted method was used based on a common assumption that the ln(HR) followed a normal distribution. The analysis was conducted on HRs to take into account adjustments on baseline characteristics made in each study. In line with previously published methodology [
If results at different follow-up times were available in a study, the longest follow-up was used. Additionally, if more than one study used the same database, only the study with the highest level of precision was used (i.e., only the study for which the standard error of the log of HR was the smallest was included). For example, 21 studies assessing dabigatran vs. VKAs based on the MarketScan® database were identified. Inclusion of studies using the same database and investigating similar outcomes could lead to the same patients being repeatedly included in the analysis, which could bias the results. Analyses did not account for different doses (i.e., data for 15 mg and 20 mg rivaroxaban doses, and 110 mg and 150 mg dabigatran doses were pooled together).
Heterogeneity between studies was assessed using the p-value of the Cochrane Q test and the I-squared, as recommended by the Cochrane Handbook for Systematic Reviews of Interventions [
Most recents protocols related to «Apixaban»
Two blood samples were collected for apixaban level measures at steady state; 1) at recruitment taken before taking their morning dose of apixaban in the morning, 2) the peak level was taken after taking apixaban within 2–4 hours. After that, blood samples were collected into two 3.2% citrated tubes to measure both the trough and peak concentrations. The blood samples were centrifuged immediately for 15 mins at 2500–3000×g [14 (link)–16 (link), 21 (link)]. Apixaban plasma levels were measured by chromogenic assay, which were performed with the BIOPHENTM heparin LRT kit (Hyphen BioMed, Neuville-sur-Oise, France) and analyzed by a Sysmex CS 2500 System (Siemens Health Care, Milan, Italy). This assay was calibrated with commercial apixaban (sensitivity range 0–600 ng/mL) and calibrated with LMWH (Low Molecular Weight Heparin) sensitivity range about 0–1.75 international units per milliliter (IU/mL). Apixaban levels were compared to the expected ranges of 69–321 ng/mL and 34–230 ng/mL for the peak and trough levels, respectively [14 (link)]. The anti-Xa levels were measured by the same method as the apixaban levels, using indirect method to standardize in the LMWH scale. All reagents and instruments were used in accordance with the manufacturers’ instructions.
Top products related to «Apixaban»
More about "Apixaban"
It works by blocking the activity of factor Xa, a crucial enzyme in the blood clotting cascade.
Apixaban has been shown to be effective in reducing the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation, and in reducing the risk of recurrent venous thromboembolism (VTE).
The medication is available in oral tablet form and is typically taken twice daily.
Apixaban is often compared to other anticoagulants like Rivaroxaban, which is another direct factor Xa inhibitor.
Researchers can utilize PubCompare.ai's innovative tools, such as AI-driven protocol comparisons and literature/patent searches, to optimize their Apixaban studies and improve research outcomes.
When conducting Apixaban research, it's important to consider related terms and assays like STA®-Liquid Anti-Xa, HemosIL, and STA-ECA II, which can be used to measure the anticoagulant effect of Apixaban.
Additionally, statistical software like SAS version 9.4 can be leveraged for data analysis.
Experiance better research outcomes with PubCompare.ai's cutting-edge tools designed to enhance the efficiency and accuracy of Apixaban studies.