만성신장병환자에서 apixaban과 warfarin의 안전성 비교: 체계적 문헌고찰 및 메타분석
- Title
- 만성신장병환자에서 apixaban과 warfarin의 안전성 비교: 체계적 문헌고찰 및 메타분석
- Other Titles
- Apixaban versus Warfarin in Patients with Chronic Kidney Disease; A Systematic Review and Meta-analysis
- Author
- 정지은
- Keywords
- Chronic kidney disease; apixaban; warfarin; bleeding; thromboembolism
- Issue Date
- 2021-06
- Publisher
- 한국임상약학회
- Citation
- 한국임상약학회지, v. 31.0, NO. 2, Page. 87-95
- Abstract
- Background: Patients with chronic kidney disease (CKD) are at a high risk of stroke-related morbidity, mortality, and bleeding. However, the overall risk/benefit of anticoagulant therapy among patients with CKD remains unclear. Methods: The MEDLINE, EMBASE, and CENTRAL databases were comprehensively searched until July 31, 2020, to investigate the safety and efficacy of apixaban in patients with stage 4 or 5 CKD, as compared with warfarin. The primary outcome was an incidence of major bleeding. Secondary outcomes included composite bleeding (major, clinically relevant, and minor bleeding), venous thromboembolism (VTE), stroke, and death. Results: In total, seven studies consisting of 10,816 patients were included. Compared with warfarin, apixaban was associated with a reduced risk of major bleeding (OR 0.49, 95% CI 0.41-0.58). In terms of composite bleeding, apixaban tended to pose a significantly lower risk than warfarin (OR 0.51, 95% CI 0.37-0.71). There was no difference between apixaban and warfarin with respect to the risk of stroke or death (stroke: OR 1.23, 95% CI 0.49-3.12; death: OR 0.73, 95% CI 0.45-1.18). Conclusion: Among patients with stage 4 or 5 CKD, the use of apixaban was associated with a lower risk of bleeding compared to warfarin and was also found to pose no excess risk of thromboembolic events.
- URI
- https://www.ekjcp.org//journal/view.html?doi=10.24304/kjcp.2021.31.2.87https://repository.hanyang.ac.kr/handle/20.500.11754/179310
- ISSN
- 1226-6051;2508-786X
- DOI
- 10.24304/kjcp.2021.31.2.87
- Appears in Collections:
- COLLEGE OF PHARMACY[E](약학대학) > PHARMACY(약학과) > Articles
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