L'utilisation des anticoagulants oraux directs chez les patients âgés : les limites de la médecine fondée sur les preuves  [The use of the new direct oral anticoagulants among older subjects: The limits of the evidence-based medicine?].

Détails

ID Serval
serval:BIB_77E36E214E3B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
L'utilisation des anticoagulants oraux directs chez les patients âgés : les limites de la médecine fondée sur les preuves  [The use of the new direct oral anticoagulants among older subjects: The limits of the evidence-based medicine?].
Périodique
La Revue de Médecine Interne
Auteur(s)
Vogel T., Lang P.O., Kaltenbach G., Karcher P.
ISSN
1768-3122 (Electronic)
ISSN-L
0248-8663
Statut éditorial
Publié
Date de publication
2015
Volume
36
Numéro
12
Pages
840-842
Langue
français
Notes
Publication types: English Abstract ; Journal Article Publication Status: ppublish
Résumé
The growing use of direct oral anticoagulants, in particular among older subjects, raises questions about the limits of the evidence-based medicine. The phase III studies that have validated the efficacy and the safety profile of these molecules (dabigatran, rivaroxaban, apixaban, edoxaban) in their both indications, the venous thromboembolic disease and the non-valvular atrial fibrillation raise concerns in four major fields: the financial support of pharmaceutical companies, the links of interest for many authors with the industry, the study design (exclusively non-inferiority studies), and the poor representativeness of the older subjects included. All these points are discussed, using data of sub-groups studies, post-marketing studies and recent meta-analysis. The lack of data for the very old subjects, with frailty or comorbidities, remains the main concern from these phase III studies.
Pubmed
Web of science
Création de la notice
14/12/2015 11:03
Dernière modification de la notice
03/03/2018 18:28
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