Podcasts about Apixaban

Today we do a round-up of some of the recent semaglutide trials. Does semaglutide ever miss? But what about tirzepatide, which causes even more weight loss?We also review two new critical care trials, FLUID and the UK-ROX, new platelet transfusion guidelines, and a new retrospective study of apixaban vs rivaroxaban vs warfarin. Oral Semaglutide for Diabetes with Cardiovascular Disease or CKD (SOUL)Semaglutide for Peripheral Artery Disease (STRIDE)Semaglutide for MASH (ESSENCE)Semaglutide vs Tirzepatide for Obesity (SURMOUNT-5)Normal Saline vs Lactated Ringers (FLUID)Conservative Oxygen Targets in Mechanically Ventilated Patients (UK-ROX)Platelet Transfusion GuidelinesApixaban vs Rivaroxaban vs Warfarin Music from Uppbeat (free for Creators!): https://uppbeat.io/t/soundroll/dope License code: NP8HLP5WKGKXFW2R

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on A Comparison of Outcomes With Apixaban, Rivaroxaban, and Warfarin for Atrial Fibrillation and/or Venous Thromboembolism.

On this special episode of JHLT: The Podcast, the Digital Media Editors take a look back at the exciting science that was on display at ISHLT2025, the ISHLT 45th Annual Meeting & Scientific Sessions. Topics include: Telomere biology disorders and lung transplantation The meeting's special focus on cardiogenic shock The apixiVAD trial exploring low dose apixaban in HeartMate 3 LVADs Myocardial recovery on durable LVADs For the latest studies from JHLT, visit jhltonline.org/current, or, if you're an ISHLT member, access your Journal membership at ishlt.org/jhlt. Full-text abstracts of the meeting can also be found at the JHLT website. Don't already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.  

What do you do when most trials suggest benefit for an intervention, but then a new trial suggests harm? We thought steroids in pneumonia was a settled question, but REMAP-CAP had other plans!We also review a new RCT for BP targets in patients with hypertension and diabetes, a new aldosterone synthase inhibitor for hypertension, and reduced dose apixaban for cancer-associated thrombosis. Hydrocortisone for Severe CAP (REMAP-CAP)Predicting Benefit of Corticosteroids in PneumoniaIntensive BP Control in Patients with Diabetes (BPROAD)Lorundrostat for Uncontrolled Hypertension (ADVANCE-HTN)Reduced Dose Apixaban for Cancer Associated Thrombosis (API-CAT)Music from Uppbeat (free for Creators!): https://uppbeat.io/t/soundroll/dope License code: NP8HLP5WKGKXFW2R

Send us a textIn this episode of CLOT Conversations, we sit down with Dr. Marc Carrier to explore a groundbreaking study published in the New England Journal of Medicine on reduced-dose apixaban for cancer-associated venous thromboembolism (VTE). Dr. Carrier breaks down the study's findings, which suggest that a lower dose of apixaban after six months of treatment is just as effective in preventing clot recurrence — and significantly safer in terms of bleeding risk. Tune in for expert insights on how this data could shift clinical practice and improve outcomes for patients living with cancer.Reference:Mahé I, Carrier M, Mayeur D, Chidiac J, Vicaut E, Falvo N, Sanchez O, Grange C, Monreal M, López-Núñez JJ, Otero-Candelera R. Extended Reduced-Dose Apixaban for Cancer-Associated Venous Thromboembolism. New England Journal of Medicine. 2025 Mar 29.Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Apixaban Dose in Patients With Atrial Fibrillation and Acute Coronary Syndrome and/or Undergoing Percutaneous Coronary Intervention: Insights From AUGUSTUS.

Returning for a second study this month, the JHLT Digital Media Editors invite first author Charlotte Van Edom to discuss the paper, “Apixaban plasma levels in patients with HeartMate 3 support.” As a cardiologist in training and a PhD candidate at the University Hospitals Leuven in Belgium, Van Edom's work focuses on hemocompatibility and mechanical circulatory support, covering both short-term and long-term support. The episode explores: The evolution of the use and understanding of direct oral anticoagulants (DOACs) during LVAD support, including the increased focus on Factor Xa inhibitors Encouraging findings from the study and what clinical practices might need to change if introducing apixaban Additional studies exploring DOACs in LVAD patients For the latest studies from JHLT, visit www.jhltonline.org/current, or, if you're an ISHLT member, access your Journal membership at www.ishlt.org/jhlt. Treat or research pulmonary vascular diseases? Check out the first April episode for a study on sotatercept in PAH patients. Don't already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.

For this episode we are joined by EBM guru, Dr. Brian Locke, who deftly breaks down all of our statistics questions. Is half dose DOAC as good as full dose DOAC for preventing VTE, and does it reduce bleeding risk? Can procalcitonin reduce duration of antibiotics for infections without compromising mortality rates? Can LLMs like GPT-4 help physicians manage patients better? Can reinforcement learning models predict when to start vasopressin in patients with septic shock? What is the risk of resuming anticoagulation in patients with atrial fibrillation and prior intracerebral hemorrhage? Is high flow nasal cannula as good as non-invasive ventilation for different types of respiratory failure? We answer all these questions and more!Half Dose DOAC for Long Term VTE Prevention (RENOVE)Biomarker-Guided Antibiotic Duration (ADAPT-Sepsis)GPT-4 Assistance for Physician PerformanceOptimal Vasopressin Initiation for Septic Shock (OVISS)DOACs for A fib after ICH (PRESTIGE-AF)High Flow Nasal Cannula vs NIV for Respiratory Failure (RENOVATE)Music from Uppbeat (free for Creators!): https://uppbeat.io/t/soundroll/dope License code: NP8HLP5WKGKXFW2R

  The RENOVE trial compared reduced-dose versus full-dose DOACs for extended venous thromboembolism VTE treatment in high-risk patients. While the reduced dose cut major bleeding risk by 39%

We're back, after a brief hiatus! Today we talk about duration of therapy for bacteremia, Factor XI inhibition for atrial fibrillation, whether to stop ACEi or ARB before elective surgery, and whether GLP-1 agonists are beneficial in heart failure with preserved ejection fraction. Go to minute 7:30 to skip the banter. 7 vs 14 Days of Antibiotics for Bacteremia (BALANCE)Abelacimab vs Rivaroxaban for Atrial Fibrillation (AZALEA-TIMI-71)Asenduxian vs Apixaban for Atrial Fibrillation (OCEANIC-AF)ACEi or ARB Discontinuation Before Surgery (STOP or NOT)Tirzepatide for HFpEF and Obesity (SUMMIT)Music from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

Drs Harrington and Gibson review their picks for the top cardiology trials of 2024 and look ahead to 2025, particularly what health topics may be prioritized by the new administration. This podcast is intended for healthcare professionals only. To read a transcript or to comment https://www.medscape.com/author/bob-harrington Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction (REDUCE AMI) https://www.nejm.org/doi/abs/10.1056/NEJMoa2401479 Intensive Blood-Pressure Control in Patients with Type 2 Diabetes (BPROAD) https://doi.org/10.1056/nejmoa2412006 Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis EARLY TAVR https://www.nejm.org/doi/full/10.1056/NEJMoa2405880 Asundexian versus Apixaban in Patients with Atrial Fibrillation (OCEANIC-AF) https://doi.org/10.1056/NEJMoa2407105 In the Wake of OCEANIC-AF, Is Equipoise Regarding Factor XI Inhibition Still Afloat? https://www.jacc.org/doi/10.1016/j.jacc.2024.10.105 Preventive percutaneous coronary intervention versus optimal medical therapy alone for the treatment of vulnerable atherosclerotic coronary plaques (PREVENT): a multicentre, open-label, randomised controlled trial https://doi.org/10.1016/S0140-6736(24)00413-6 Preventive Coronary Stents: Not There Yet https://www.medscape.com/viewarticle/preventive-coronary-stents-not-there-yet-2024a10006yr Speech by Commissioner Robert M. Califf to the House of Medicine June 16, 2023 https://www.fda.gov/news-events/speeches-fda-officials/speech-commissioner-robert-m-califf-house-medicine-06162023 Evolution of Single-Lead ECG for STEMI Detection Using a Deep Learning Approach https://doi.org/10.1016/j.ijcard.2021.11.039 From ST-Segment Elevation MI to Occlusion MI: The New Paradigm Shift in Acute Myocardial Infarction https://doi.org/10.1016/j.jacadv.2024.101314 You may also like: Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances discusses a recently published original research paper on apixaban and limiting aspirin for patients with atrial fibrillation, percutaneous coronary intervention, and multimorbidity.

On the top 200 drugs podcast, we cover 5 more medications. The medications covered on today's episode include; omalizumab, nitroglycerin, apixaban, gabapentin, and etanercept. Omalizumab is a monoclonal antibody used in moderate to severe asthma. It targets IgE-mediated asthma attacks and reactions. Anaphylaxis is a significant concern with the use of this medication. Sublingual nitroglycerin is frequently used on an as needed basis for angina symptoms. I discuss major drug interactions and much more. Apixaban is an anticoagulant used to prevent stroke in atrial fibrillation. It can also be used in DVT/PE treatment and prevention. Gabapentin is classified as an antiepileptic agent but is most commonly used for neuropathic type pain. Etanercept targets TNF alpha which plays an important role in autoimmune diseases such as rheumatoid arthritis.

It's been a long time, but we are back!Apologies on the audio quality from Dr. Jenkins. Apparently he was recording from inside a cardboard box.Today we talk about important, practice changing studies in internal medicine from the last several months. What's the best anticoagulant in patients with cirrhosis and atrial fibrillation? Why do doctors use so much unfractionated heparin for acute PE? Should we still be using beta blockers in patients with acute MI? Does finerenone improve outcomes in HFpEF? Is continuous infusion of antibiotics better than intermittent? And will the cefepime vs piperacillin-tazobactam battle ever end?Apixaban, Rivaroxaban and Warfarin in Cirrhosis for AFAnticoagulation Trends for Acute PEBeta Blockers for Acute MI with Normal EF Finerenone for HFpEF FINEARTS-HFContinuous vs Intermittent Infusion of Beta-Lactams BLING IIIProlonged vs Intermittent Infusions of Beta-Lactams Meta-analysisPiperacillin-Tazobactam vs Cefepime for SepsisRecurrent SBP in Patients on Secondary Prophylaxis

Join moderator Melissa Middeldorp as she discusses the NEJM article Asundexian versus Apixaban in Patients with Atrial Fibrillation with Christopher C Cheung, MD, MPH and Prashanthan Sanders, MBBS, PhD, FHRS at HRS2024 in Atalnta. This episode is brought to you live from the HRSTV Studio and comes with bonus video footage. https://www.hrsonline.org/education/TheLead https://www.nejm.org/doi/full/10.1056/NEJMoa2407105 Host Disclosure(s): M. Middeldorp: Nothing to disclose.   Contributor Disclosure(s): C. Cheung: Nothing to disclose. P. Sanders: Membership on Advisory Committees: Boston Scientific, Medtronic PLC, Pacemate, CathRx, Research: Abbott, Becton Dickinson, Boston Scientific, CathRx, Medtronic, Pacemate.

Pedro Magno e Kaue Malpighi falam sobre o passo a passo da prescrição de rivaroxabana e apixabana: quando indicar? o que orientar o paciente? qual dose tomar? Tudo nesse episódio! No Guia TdC comentamos sobre como reverter o sangramento associado aos DOACs. Você pode ler esse tópico gratuitamente, basta clicar no link abaixo e fazer o login: Manejo de Sangramento Maior em Pacientes em Uso de Anticoagulante Oral | Guia TdC (tadeclinicagem.com.br) Referência: Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41(4):543-603. doi:10.1093/eurheartj/ehz405 Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS) [published correction appears in Eur Heart J. 2021 Feb 1;42(5):507. doi: 10.1093/eurheartj/ehaa798] Siontis KC, Zhang X, Eckard A, et al. Outcomes Associated With Apixaban Use in Patients With End-Stage Kidney Disease and Atrial Fibrillation in the United States [published correction appears in Circulation. 2018 Oct 9;138(15):e425. doi: 10.1161/CIR.0000000000000620]. Circulation. 2018;138(15):1519-1529. doi:10.1161/CIRCULATIONAHA.118.035418 Holt A, Strange JE, Rasmussen PV, et al. Bleeding Risk Following Systemic Fluconazole or Topical Azoles in Patients with Atrial Fibrillation on Apixaban, Rivaroxaban, or Dabigatran. Am J Med. 2022;135(5):595-602.e5. doi:10.1016/j.amjmed.2021.11.008 Beyer-Westendorf J, Siegert G. Of men and meals. J Thromb Haemost. 2015;13(6):943-945. doi:10.1111/jth.12973

Editor-in-Chief Eric Rubin and Deputy Editor Jane Leopold discuss research that was presented at the 2024 European Society of Cardiology annual meeting. Visit NEJM.org to read the latest research.

Audio Commentary by Dr. Valentin Fuster, Emeritus Editor in Chief

In less than 15 minutes, Medmastery's Cardiology Digest will give you the low-down on some of the most compelling studies in cardiology that clinicians with an interest in cardiovascular health need to know about. STUDY #1: We kick things off by exploring exactly where the CHA2DS2-VASc score fits into anticoagulation decisions in patients with silent atrial fibrillation. Building on the main findings from the ARTESiA and NOAH-AFNET 6 trials, this study sparks a thought-provoking discussion on the future of risk stratification. Tune in to hear insights that could shape your clinical practice.  Lopes, RD, Granger, CB, Wojdyla, DM, et al. 2024. Apixaban versus aspirin according to CHA2DS2-VASc score in subclinical atrial fibrillation: Insights from ARTESiA. J Am Coll Cardiol. In Press, Journal Pre-proof. (https://doi.org/10.1016/j.jacc.2024.05.002) STUDY #2: Next, we break down misconceptions surrounding race and treatment efficacy in heart failure with reduced ejection fraction. This study shines a light on the impacts of renin-angiotensin system inhibition across different racial groups. See how these findings challenge the outdated genetic constructs of race, and what they mean for your approach to patient care. Shen, L, Lee, MM, Jhund, PS, et al. 2024. Revisiting race and the benefit of RAS blockade in heart failure: A meta-analysis of randomized clinical trials. JAMA. 24: 2094–2104. (https://doi.org/10.1001/jama.2024.6774) STUDY #3: Finally, we turn our focus to the V142I transthyretin gene variant, to evaluate its impacts on cardiovascular health within the U.S. Black population. This research not only highlights the need for targeted genetic screening but also raises important questions about the accessibility of costly treatments for transthyretin amyloidosis. Selvaraj, S, Claggett, B, Shah, SH,  et al. 2024. Cardiovascular burden of the V142I transthyretin variant. JAMA. 21: 1824–1833. (https://doi.org/10.1001/jama.2024.4467) Maurer, MS, Miller, EJ, Ruberg, FL, et al. 2024. Addressing health disparities—The case for variant transthyretin cardiac amyloidosis grows stronger. JAMA. 21: 1809–1811. (https://doi.org/10.1001/jama.2024.2868) Yancy, CW. 2024. Heart failure in African American individuals, Version 2.0. JJAMA. 21: 1807–1808. (https://doi.org/10.1001/jama.2024.5217) Don't miss out on this rich discussion that promises to enhance your understanding and expertise!  Learn more with these courses: Medical Treatment of Heart Failure (2 CME) Atrial Fibrillation Management Essentials (1 CME) Get a Basic or Pro account, or, get a Trial account. Show notes: Visit us at  https://www.medmastery.com/podcasts/cardiology-podcast.

In this episode of Medmastery's Cardiology Digest, we delve into a trio of intriguing cardiology studies that raise as many questions as they answer. Whether you're a seasoned clinician or a medical student, these studies have implications that could influence your approach to patient care. STUDY #1: First, we turn our attention to the role of GLP-1 agonists in cardiovascular disease prevention among non-diabetic patients who are overweight or obese. With a focus on injectable semaglutide this study examines its cost-effectiveness and potential side effects. The findings might alter how we manage cardiovascular risk in these patients!  Lincoff AM et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med 2023 Nov 11; [e-pub]. (https://doi.org/10.1056/NEJMoa2307563) STUDY #2: Next, we'll explore a compelling meta-analysis that could sway future guidelines and recommendations. They evaluated the outcomes of physiologic guidance and intravascular imaging in percutaneous coronary interventions (PCI), to see if these techniques improve patient outcomes beyond what's possible with angiographic guidance alone. Kuno T et al. Comparison of intravascular imaging, functional, or angiographically guided coronary intervention. J Am Coll Cardiol 2023 Dec 5; 82:2167. (https://doi.org/10.1016/j.jacc.2023.09.823) STUDY #3: Finally, we're going to examine the nuances of anticoagulation in patients with subclinical atrial fibrillation. The balance between preventing strokes and avoiding bleeding complications is a delicate one. With new data suggesting nuanced approaches, this segment will provide valuable insights for us when we're prescribing or considering anticoagulation therapies. Healey JS et al. Apixaban for stroke prevention in subclinical atrial fibrillation. N Engl J Med 2023 Nov 12; [e-pub]. (https://doi.org/10.1056/NEJMoa2310234) Svennberg E. What lies beneath the surface — Treatment of subclinical atrial fibrillation. N Engl J Med 2023 Nov 12; [e-pub]. (https://doi.org/10.1056/NEJMe2311558) Join us to explore the potential impacts of these studies, the ongoing debates they spark within the cardiology community, and to see how these findings could influence your clinical decisions. Learn more with these courses: Percutaneous Coronary Intervention Essentials (6 CME) Percutaneous Coronary Intervention Essentials Workshop (6 CME) Show notes: Visit us at  https://www.medmastery.com/podcasts/cardiology-podcast.

Show notes at pharmacyjoe.com/episode913. In this episode, I’ll discuss the efficacy tradeoff when reducing apixaban dose in patients with end-stage renal disease. The post 913: Is there an efficacy tradeoff when reducing apixaban dose in patients with end-stage renal disease? appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode912. In this episode, I’ll discuss whether standard doses of apixaban are as effective as warfarin in severe obesity. The post 912: Are Standard Doses of Apixaban as Effective as Warfarin in Patients With Severe Obesity? appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode912. In this episode, I’ll discuss whether standard doses of apixaban are as effective as warfarin in severe obesity. The post 912: Are Standard Doses of Apixaban as Effective as Warfarin in Patients With Severe Obesity? appeared first on Pharmacy Joe.

On this episode of the Real Life Pharmacology podcast, I take a dive into the most common mechanisms of drug interactions. Below I list some of the common drug interactions seen in practice and how they work! Opposing Effects Many drugs will work on various receptors throughout the body. To use as an educational point, there is no better example to point to than the beta receptor. Beta-blockers are frequently used in clinical practice for their ability to lower blood pressure and slow the heart rate. Both of these beneficial actions are primarily achieved by blocking the effects of beta-1 receptors. Some beta-blockers have action on alternative beta receptors. Propranolol is one such beta-blocker that is classified as a non-selective beta-blockers. This means that in addition to the positive effects on beta-1 receptors, it can also have blocking effects on beta-2 receptors. The blockade of the beta-2 receptor by propranolol can also be life-changing. It can directly oppose beta-2 agonists like albuterol from having their beneficial effects of opening up the airway. Enzyme Inhibition Medication metabolism is arguably the largest and most clinically significant source for drug interactions. Medications that are primarily metabolized by enzymes in the liver can be greatly affected if we affect how those enzymes work. CYP3A4 is one of the most well studied and well-known enzymes that can impact hundreds to maybe even thousands of drugs. Apixaban is an oral anticoagulant that is broken down at least in part by CYP3A4. By using a CYP3A4 inhibitor like erythromycin, there is the potential to raise concentrations of apixaban. This could lead to a higher risk of bleeding. Enzyme Induction Carbamazepine is a drug that you must know. This drug is a potent enzyme inducer. This differs significantly from an enzyme inhibitor and will have the exact opposite clinical effect. Drugs that are inactivated by liver enzymes will be inactivated more quickly in a patient taking an enzyme inducer. Going back to our prior apixaban example above, carbamazepine can induce CYP3A4 and facilitate a more efficient and swifter breakdown of the drug. Bleeding will be less likely. The risk for treatment failure, usually in the form of a blot clot, will be more likely.  Here's more information from the past on carbamazepine. Alteration in Absorption Binding interactions can be consequential and are one of the most common types of drug interactions. Many medications have the potential to bind one another in the gut. This can lead to lower concentrations of a specific medication. Calcium and iron are two of the most common examples of medications that can bind other drugs. Alteration in Protein Binding By remembering that unbound drug is an active drug, you should appreciate the risk for protein binding alterations. A significant number of medications can bind proteins in the bloodstream. As this occurs, that drug is not freely available to create physiologic effects. When another medication is added that can also bind these proteins, this can displace other medications and increase the quantity of free drug in the bloodstream. This essentially allows for enhanced physiologic effects. Warfarin is a medication that is highly protein-bound. When another drug is added that can kick warfarin off of those protein binding sites, it can free up warfarin which will increase the likelihood of elevating the patient's INR and increase their bleed risk. Alteration in Renal Elimination Some drugs can alter the way other medications are eliminated through the kidney. Chlorthalidone, like all thiazide diuretics, has the potential to block the excretion of lithium from the kidney. This can lead to lithium toxicity. This type of interaction, while significant, is much less common than drug interactions involve the liver and CYP enzyme pathways.   Effects on Transporters One of the last types of drug interactions is the effe...

Commentary by Dr. Valentin Fuster

Join InpharmD as we discuss the role of apixaban in peripheral artery disease.

Janice Y. Chyou, MD, FHRS, of Icahn School of Medicine at Mount Sinai is joined by guests Jonathan P. Piccini, Sr., MD, MHS, FHRS, of Duke University Medical Center, and Mintu P.Turakhia, MD, MS, of iRhythm Technologies and Stanford University to have A Discussion of Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation. Subclinical atrial fibrillation is short-lasting and asymptomatic and can usually be detected only by long-term continuous monitoring with pacemakers or defibrillators. Subclinical atrial fibrillation is associated with an increased risk of stroke by a factor of 2.5; however, treatment with oral anticoagulation is of uncertain benefit. Among patients with subclinical atrial fibrillation, apixaban resulted in a lower risk of stroke or systemic embolism than aspirin but a higher risk of major bleeding.   https://www.hrsonline.org/education/TheLead https://www.nejm.org/doi/full/10.1056/NEJMoa2310234   Host Disclosure(s): J. Chyou: Honoraria/Speaking/Consulting Fee: McGraw-Hill, American Heart Association; Membership (Advisory Committee): American Heart Association   Contributor Disclosure(s): J. Piccini: Honoraria/Speaking/Consulting Fee: Biotronik, AbbVie, LivaNova, Boston Scientific, Phillips, Medtronic, Electrophysiology Frontiers, Abbott, UpToDate, Inc., Sanofi, Milestone Pharmaceuticals, Bayer Healthcare Pharmaceuticals; Research (Contracted Grants for PIs Named Investigators Only): Boston Scientific, Bayer Healthcare Pharmaceuticals, AMA, Abbott, Phillips, Element Science, Inc., iRhythm Technologies, NIH   M. Turakhia: Research (Contracted Grants for PIs Named Investigators Only): Bristol-Myers Squibb, FDA Circulatory System Devices Panel, American Heart Association, Bayer Healthcare Pharmaceuticals, Sanofi; Stocks (Board Membership): 100Plus; Employment: iRhythm Technologies

AHA23 Congress Coverage: Apixaban in subclinical AF (ARTESIA)

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: July 18, 2017 Long-term antithrombotic treatment of embolic stroke sounds like a tricky field to navigate. Aspirin is the drug of choice in the acute setting for most patients, but when cardioembolic stroke is suspected, aspirin is inferior to anticoagulation for preventing recurrent stroke. In the age of novel oral anticoagulants, why choose warfarin and risk drug interactions, dietary restrictions, and bleeding risk? In this episode, we discuss the pros and cons of each of the major NOACs for secondary stroke prevention. Enjoy! BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. REFERENCES Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009;361(12):1139-51. Erratum in: N Engl J Med 2010;363(19):1877. PMID 19717844Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2013;369(22):2093-104. PMID 24251359Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011;365(11):981-92. PMID 21870978Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011;365(10):883-91. PMID 21830957 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

Show notes at pharmacyjoe.com/episode852. In this episode, I’ll discuss a study about the safety of apixaban in patients with renal insufficiency. The post 852: Does Europe Do Apixaban Renal Dosing Better (Safer) Than the US? appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode852. In this episode, I’ll discuss a study about the safety of apixaban in patients with renal insufficiency. The post 852: Does Europe Do Apixaban Renal Dosing Better (Safer) Than the US? appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode849. In this episode, I’ll discuss the treatment of norepinephrine extravasation. The post 849: Should apixaban’s loading dose duration ever be shortened? appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode849. In this episode, I’ll discuss the treatment of norepinephrine extravasation. The post 849: Should apixaban’s loading dose duration ever be shortened? appeared first on Pharmacy Joe.

How do concomitant meds affect antidepressant response? Find out about this and more in today's PV Roundup podcast.

Show notes at pharmacyjoe.com/episode830. In this episode, I'll discuss using heparin anti-Xa levels to evaluate apixaban, rivaroxaban, fondaparinux, and danaparoid levels. The post 830: Using Heparin Anti-Xa Levels to Evaluate Apixaban, Rivaroxaban, Fondaparinux, or Danaparoid Levels appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode830. In this episode, I ll discuss using heparin anti-Xa levels to evaluate apixaban, rivaroxaban, fondaparinux, and danaparoid levels. The post 830: Using Heparin Anti-Xa Levels to Evaluate Apixaban, Rivaroxaban, Fondaparinux, or Danaparoid Levels appeared first on Pharmacy Joe.

Today we have a special guest, Dr. Joel Topf, board-certified nephrologist and medical educator extraordinaire. Our listeners will likely recognize Dr. Topf from his prolific tweeting @Kidney_boy, as well as his numerous appearances on the Curbsiders podcast. He is a co-founder of the NephJC on Twitter, and host and founder of the NephJC podcast Freely Filtered. He is also host of the podcast Channel Your Enthusiasm, a deep dive monthly recap of the nephrology textbook Clinical Physiology of Acid Base and Electrolyte Disorders by Dr. Burton Rose (who, incidentally, is the creator of the original UpToDate). Dr. Topf wrote his own book on fluids, electrolytes and acid-base homeostasis.  He's the co-editor for the fourth edition of Nephrology Secrets and the first edition of The Handbook of Critical Care Nephrology. Dr. Topf joined us to talk about a new paper he co-authored on osmotic demyelination syndrome and hyponatremia. I'm also joined by Dr. Mita Hoppenfeld, hospitalist at the University of Utah, to talk about a new DOAC vs warfarin trial in On-X aortic valves, whether it's better to avoid hypertension or hypotension around time of surgery, and the diagnostic accuracy of CT abdomen scans without contrast. Check it out! Osmotic Demyelination and HyponatremiaApixaban vs Warfarin for On-X Aortic ValvePerioperative Blood Pressure Strategies Diagnostic Accuracy of CT Abdomen Without ContrastMusic from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

This episode covers the basics of the oral anticoagulant Eliquis. The episode covers the indications, mechanism of action, common dosing, reversal, and a comparison to Coumadin. 

Welcome back Rounds Table Listeners! We are back today with our Classic Rapid Fire Podcast! This week, Drs. John and Mike Fralick discuss two recent papers – one, exploring the use of molnupiravir for the treatment of COVID-19 in adults at increased risk of adverse outcomes, and the second investigating the the use of apixaban ...The post Episode 57 – Molnupiravir for COVID-19 and Apixaban for Atrial Fibrillation in Hemodialysis appeared first on Healthy Debate.

Welcome back Rounds Table Listeners! We are back today with our Classic Rapid Fire Podcast! This week, Drs. John and Mike Fralick discuss two recent papers – one, exploring the use of molnupiravir for the treatment of COVID-19 in adults at increased risk of adverse outcomes, and the second investigating the the use of apixaban ... The post Episode 57 – Molnupiravir for COVID-19 and Apixaban for Atrial Fibrillation in Hemodialysis first appeared on Healthy Debate. The post Episode 57 – Molnupiravir for COVID-19 and Apixaban for Atrial Fibrillation in Hemodialysis appeared first on Healthy Debate.

We're back with Season 4! Sorry for the unplanned hiatus. Today we talk about the CLOVERS trial, which tested the hypothesis that early vasopressors and restrictive fluid would be superior to liberal fluids plus rescue vasopressors. We also looked at the TRANSFORM-HF study, which compared torsemide and furosemide in congestive heart failure, the PREVENT CLOT study, which compared aspirin to enoxaparin for VTE prophylaxis after a traumatic fracture, and the AID-ICU study, which compared haloperidol to placebo in the treatment of ICU delirium. CLOVERS trialTorsemide vs Furosemide in CHFAspirin vs Enoxaparin for VTE ppx after FractureIV Haloperidol in ICU DeliriumWe also quickly review some papers we missed in 2022:Apixaban for VTE in ESRD Acetazolamide for Congestive Heart FailureModerate or Aggressive IV Fluids for PancreatitisPerioperative Management of AnticoagulationCRISTAL study (aspirin vs enoxaparin after TKA/THA)Music from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

This week, please join author Sean Pokorney and Associate Editor Shinya Goto as they discuss the article "Apixaban for Patients With Atrial Fibrillation on Hemodialysis: A Multicenter Randomized Controlled Trial." Dr Carolyn Lam:               Welcome to Circulation on the Run, your weekly podcast summary and Backstage Pass of the journal and its editors. We're your cohost. I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center and Duke National University of Singapore. Dr Greg Hundley:            And I'm Dr. Greg Hundley, Associate Editor, Director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Carolyn, this week's feature, very interesting topic. In patients that have end stage renal disease that require dialysis, questions emerged should we anticoagulate them to prevent stroke, but of course, there's a risk of excess bleeding. Well, this feature discussion today is a study comparing apixaban and warfarin for anticoagulation in exactly this patient population. But before we get to those results, how about we grab a cup of coffee and go through some of the other articles in the issue? Would you like to go first? Dr Carolyn Lam:               Absolutely, Greg. So my first paper is a pre-specified analysis of the Paradise MI trial and knowing you'll likely ask me what that was about, Greg, at least to summarize for everyone, the Paradise MI trial compared sacubitril/valsartan with ramipril and its effect on reducing heart failure events after an MI in more than 5,600 patients with an acute myocardial infarction complicated by LV systolic dysfunction, pulmonary congestion, or both. Now in today's paper, what Dr. Mehran and colleagues found was that among patients with a recent AMI and LV systolic dysfunction, heart failure are both, sacubitril/valsartan decreased the risk of coronary related events by 14% as compared with ramipril over a median follow-up of 22 months. The reduction in coronary events occurred with a favorable safety profile. Dr Greg Hundley:            Wow, Carolyn, very interesting. Another indication perhaps for sacubitril/valsartan, especially relative to ACE inhibitors. So what does this mean for us clinically? Dr Carolyn Lam:               Well, the results really cause us to consider if in addition to antiplatelets and lipid lowering therapies, sacubitril/valsartan may be explored as a potential agent to mitigate the residual risk in survivors of AMI. Of course, dedicated studies are necessary to confirm this finding and elucidate its mechanism. Dr Greg Hundley:            Oh, very nice, Carolyn. Well, my first paper comes to us from the World of Preclinical Science and Carolyn, this study evaluated the scavenger receptors stabilin-1 and stabilin-2, proteins that are preferentially expressed by liver sinusoidal endothelial cells. Now, they mediate the clearance of circulating plasma molecules controlling distant organ homeostasis. And studies suggest that stabilin-1 and stabilin-2 may impact atherosclerosis. So in this study, the investigative team led by Professor Cyrill Géraud from the University Medical Center and Medical Faculty in Mannheim, Heidelberg comprehensively studied how targeting stabilin-1 and stabilin-2 affects atherosclerosis. Dr Carolyn Lam:               Huh. All right, nicely explained. And so what did they find, Greg? Dr Greg Hundley:            Right, Carolyn. So inhibition of evolutionary conserved class H scavenger receptors, stabilin-1 and stabilin-2, reduced aortic plaque burden in preclinical models and athero protection was mediated likely through down regulation on transcriptional factor ERG1 in monocytes by multifaceted plasma protein changes. And then finally, Carolyn transforming growth factor beta induced periostin, reelin, and they are novel ligands of stabilin-1 and stabilin-2 and are implicated in the development of atherosclerosis. Dr Carolyn Lam:               Okay. Wow. Could you give us a take home message, please Greg? Dr Greg Hundley:            Right. Carolyn, I knew you had asked me this. So here we go. Monoclonal, anti-stabilin-1 and anti-stabilin-2 antibodies provide a novel approach for the future treatment of atherosclerosis. And in the future, perhaps the plasma proteome composition may serve as a predictive factor, biomarker or surrogate parameter for cardiovascular disease in patients. Dr Carolyn Lam:               Wow. Thanks Greg. My next paper is a true story of discovery. Now I could ask you what you know about the condition hypertension with brachydactyly type E... Greg, I love that expression. I wouldn't be able to answer that too. So let me tell you the story. So hypertension with brachydactyly type E is an autosomal dominant Mendelian disease resembling essential hypertension. Untreated patients die of stroke by the age of 50 years. Now, these authors had previously demonstrated a gain of function phosphodiesterase 3A gene mutations that caused the condition by increasing peripheral vascular resistance. They studied a large family with the condition earlier and were puzzled that cardiac hypertrophy and heart failure did not occur despite the decades of hypertension. And so they hypothesized that in the heart, this phosphodiesterase 3A or PDE3A mutations could be protective. Isn't that neat? And so corresponding authors, Doctors Bader, Klussmann, Bähring and Hübner, all from the Max Delbruck Center for Molecular Medicine in Berlin, Germany. So they studied new patients as well as CRISPR-Cas9 engineered rat models of this condition of hypertension with brachydactyly type E. And they comprehensively phenotyped all of them with the human induced pluripotent stem cells carrying these PDE3A mutations as well. So analyzing all of this from cells to new patients to CRISPR-Cas9 models. Dr Greg Hundley:            Wow, Carolyn, what an interesting story. So what did they find? Dr Carolyn Lam:               So while in vascular smooth muscle, the PDE3A mutations caused hypertension, in the hearts, they conferred protection against hypertension-induced cardiac damage, hypertrophy and heart failure. The mechanism involved long-term adaptations of mRNA and protein expression as well as calcium cycling. Non-selective PDE3A inhibition was a final short term option in heart failure treatment to increase cardiac cyclic AMP and improve contractility. So the data argued that mimicking the effect of PDE3A mutations in the heart rather than non-selective PDE3 inhibition was cardioprotective in the long term. And these findings could indeed facilitate the search for new treatments to prevent hypertension-induced cardiac damage. This is discussed in a really lovely editorial by Dr. Chiong, Houslay, and Lavandero. Dr Greg Hundley:            Very nice, Carolyn. Wow. What another... we have such great articles from the World of Preclinical Science. Beautiful description as well. Well, we have some other articles in the issue, particularly from the Mailbag. And we have a Research Letter from Professor Thiagarajan entitled “Yield of Cardiac MRI in a pre-participation cohort of Young Asian males with T-Wave inversion.” Dr Carolyn Lam:               Interesting. There's an exchange of letters between Dr. Xu and Huang regarding the article associations of dietary cholesterol, serum cholesterol and egg consumption with overall and cause-specific mortality with a systematic review and updated meta-analysis. There is a Perspective piece by Dr. Marcus on Smart watch detected atrial fibrillation, the value in positive predictive value. Isn't that interesting? And now onto that very, very important question of anticoagulation in patients with kidney disease. Can't wait. Let's go, shall we? Dr Greg Hundley:            You bet. Carolyn. Welcome listeners to our December 6th feature discussion. And we have with us today Dr. Sean Pokorney from Duke University in Durham, North Carolina, and our associate editor, Dr. Shinya Goto from Tokai University in Isehara, Japan. Welcome gentlemen. Well, Sean, we're going to start with you. Can you describe for us some of the background information that went into the preparation of your study and what was the hypothesis that you wanted to address? Dr. Sean Pokorney:         Yeah, absolutely. Thanks for having me to discuss the renal AF trial. And so I would say that the background information to the study was that we know that atrial fibrillation is an incredibly common condition in patients with chronic kidney disease. And the decision of anticoagulation in patients with end-stage kidney disease, on hemodialysis is really quite complex because these patients are at high risk for stroke and they're at high risk for bleeding. There are concerns with warfarin around calcific uremic arteriolopathy or calciphylaxis and there have been some data including from the original Aristotle trial that apixaban was even more favorable in terms of bleeding reduction relative to warfarin in patients with more advanced chronic kidney disease. Although patients with creatinine clearance less than 25 were excluded from Aristotle and really all patients with endstage kidney disease on hemodialysis have been excluded from all trials of atrial fibrillation in the past. And so we really wanted to evaluate the safety of apixaban versus warfarin in patients with end-stage kidney disease, on hemodialysis. And the hypothesis was that apixaban was going to be non-inferior to warfarin with respect to safety in terms of major or clinically relevant, non-major bleeding in these patients with atrial fibrillation and end stage kidney disease on hemodialysis. Dr Greg Hundley:            Thanks so much, Sean. And you've mentioned the renal AF trial. So could you describe for us, for your, I guess, substudy, what was the study population? Who did you include and describe for us also your study design? Dr. Sean Pokorney:         Yeah, absolutely. So the trial included patients who had end-stage kidney disease, and/or on hemodialysis, as well as having concomitant atrial fibrillation. And the patients had to have a CHA-VASc score greater than equal to two. All of the patients had to be on hemodialysis for at least three months. So these were chronic hemodialysis patients. And the study design was an open label randomized trial that was 1:1 randomization between apixaban and warfarin with blinded outcome evaluation. And again, the primary endpoint of the study was major or clinically relevant non-major bleeding based on ISTH definitions. And there were secondary endpoints looking at stroke, systemic embolism, death, medication adherence, and I think a really important sub-study looking at PK data. And the goal was to have 50 patients where we included PK data that was going to more represent what chronic apixaban dosing data would look like in these patients with end-stage kidney disease on hemodialysis. And originally the goal of the trial was to include over 700 patients. Originally we were trying to include 762 patients based on our initial power calculations to achieve true non-inferiority. Unfortunately, the trial enrollment was low and so the trial was ultimately stopped prematurely at 154 patients, although we were able to include the original targeted 50 patients in the PK substudy. The dosing that we used in the renal AF trial was 5 mg of apixaban twice daily unless patients had a second dose-reduction criteria in addition to chronic kidney disease. So the fact that they had end-stage kidney disease and were on hemodialysis counted as one dose reduction criteria and patients that were under 60 kilograms or less were 80 years of age or older, who had then a second dose-reduction criteria were treated with the 2.5 mg twice daily dosage. And this was important to note because this is different than the dosage that was used in the AXADIA-AFNET trial. Dr Greg Hundley:            Very nice. And so Sean, what did you find? Dr. Sean Pokorney:         Yeah. So again, a lot of this data is really exploratory because of the limited sample size, we weren't really able to definitively conclude anything about the major or clinically relevant non-major bleeding rates. I would say that some of the key findings that we saw was that there were high rates of major or clinically relevant non-major bleeding in both arms of the trial and one year bleeding event rates were 25% in the warfarin arm and 31% in the apixaban arm. And again, there was no statistically significant difference, although again, this is really exploratory. I would say that some of the other interesting findings that we saw was that there were very low rates of ischemic and hemorrhagic stroke in this patient population. Again, there were 82 patients randomized to apixaban, 72 patients randomized to warfarin. And there was a difference in the randomization because of the stratification by site that was performed with the randomization. And so within the 82 patients that were randomized to apixaban, the patients, there was one ischemic stroke and one hemorrhagic stroke. There were no hemorrhagic strokes in the warfarin population and two ischemic strokes. Another key finding was the high rates of mortality in this patient population. So 26% of the apixaban patients experienced a mortality event, 18% in the warfarin arm. So again, the mortality rates in these patient populations were extremely high. I would also emphasize some of the data from the PK analysis. So we looked at the PK analysis in two different ways. For the patients that were treated with the 5 mg dose of apixaban, the PK data showed that there was consistent overlap in the steady state concentration at one month compared to patients in the Aristotle trial that had really mild to moderate, moderate to severe and severe chronic kidney disease. And so there was a consistent overlap in those steady state concentrations between the end-stage kidney disease population on hemodialysis and the chronic kidney disease population who benefited from a apixaban in the Aristotle trial. Similarly, in the 2.5 mg apixaban dose, the patient who had a second dose reduction criteria in addition to chronic kidney disease, those patients had consistent steady state concentrations of apixaban relative to patients with mild to severe chronic kidney disease. Dr Greg Hundley:            Very nice. Well thank you so much, Sean. And listeners, now we're going to turn to our associate editor, Dr. Shinya Goto. Shinya, can you, sort of, highlight for us some of the interesting findings that you see from these study results that Sean just presented? Dr. Shinya Goto:              Thank you, Greg. Thank you, Sean for your wonderful summary of your study. We had a great discussion with an editor for this paper. As Sean pointed out, this is a kind of underpowered trial or just terminated early, hypothesis was not tested in the trial. But this population of patient clearly needs a real-world clinical trial, patient with atrial fibrillation, end-stage kidney disease, on hemodialysis; things a clinician could do. In some country, nephology society defined warfarin contraindicated in this population. As Sean pointed out, whether the development of this trial include this high-risk population patient. So we had a discussion whether the underpowered trial provided something or nothing may be better than something just provided here. Our consensus finally reached was, this limited trial still provide something like, you have to make a decision to use the anticoagulation. I mean, that the apixaban might be still used due to the PK data. That is the kind of interesting point of this trial. Dr Greg Hundley:            Very nice Shinya. Well, Sean, turning back to you and Shinya with that nice lead in really, Sean, what do you think is the next study that needs to be performed in this sphere of research? Dr. Sean Pokorney:         Yeah, absolutely. I think this is a challenging patient population to study. And again, our trial, the renal AF trial stopped early. Unfortunately, the AXADIA-AFNET 8 study also stopped early, which was also looking at apixaban versus warfarin outside the US and Europe. And so again, it is a challenging patient population to study. But again, I also think it's a really important population to study because one of the main unanswered questions in this population is whether or not they should receive anticoagulation. And so I think that ultimately more work and additional studies trying to determine whether or not these patients truly benefit from anticoagulation or stroke prevention, I think is really one of the critical directions that we need to take the field in. Dr Greg Hundley:            And Shinya, do you have anything to add? Dr. Shinya Goto:              Well, I fully agree with Sean. I mean, this is a very challenging area and still raising the question whether anticoagulation is necessary or not by your study. Maybe next generation oral anticoagulant such as Factor XI inhibitor that is more elevated to contact pathway may be beneficial. So we really need a good clinical study in this very important and known answered area. Dr Greg Hundley:            Very nice. Well listeners, we want to thank Dr. Dr. Sean Pokorney from Duke University in Durham, North Carolina and our own associate editor, Dr. Shinya Goto from Tokai University in Japan for bringing us the results of this randomized open-label trial of apixaban versus warfarin in patients with chronic kidney disease on hemodialysis, revealing high rates of bleeding in both groups, but due to low enrollment, was unable to identify its non-inferiority endpoint. It's important to note, however, as both our author and editorialists have identified further research is really needed in this area to really examine the efficacy of anticoagulation for stroke prevention in this high-risk patient population. Well, on behalf of Carolyn and myself, we want to wish you a great week and we will catch you next week On The Run. Dr. Greg Hundley:           This program is copyright of the American Heart Association 2022. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.

This week on Pharm5: Eliquis v. Xarelto for AFib Improve M&M by quickly titrating HFrEF treatments National Adderall shortage Novavax ok'd as booster Student loan forgiveness application Connect with us! Listen to our podcast: Pharm5 Follow us on Twitter: @LizHearnPharmD References: Dawwas GK, Cuker A, Barnes GD, Lewis JD, Hennessy S. Apixaban versus rivaroxaban in patients with atrial fibrillation and valvular heart disease. Annals of Internal Medicine. October 2022. doi:10.7326/m22-0318 Strong-HF study in patients admitted for acute heart failure (HF) terminated early for superior efficacy. STRONG-HF study in patients admitted for acute heart failure (HF) terminated early for superior efficacy. https://prn.to/3sbDrMv. Published October 13, 2022. Accessed October 14, 2022. Safety, tolerability, and efficacy of rapid optimization, helped by NT-probnp testing, of heart failure therapies - full text view. Safety, Tolerability and Efficacy of Rapid Optimization, Helped by NT-proBNP testinG, of Heart Failure Therapies - Full Text View - ClinicalTrials.gov. https://bit.ly/3MQktVd. Accessed October 14, 2022. Brooks M. FDA confirms nationwide Adderall shortage. Medscape. https://wb.md/3DfXS0O. Published October 14, 2022. Accessed October 14, 2022. FDA drug shortages. FDA. https://bit.ly/3yZiAzG. Accessed October 14, 2022. CDC allows Novavax monovalent COVID-19 boosters for adults ages 18 and older. Centers for Disease Control and Prevention. https://bit.ly/3VM10J9. Published October 19, 2022. Accessed October 20, 2022. Center for Biologics Evaluation and Research. Novavax COVID-19 vaccine. U.S. Food and Drug Administration. https://bit.ly/3eMcbkC. Accessed October 20, 2022. Federal Student Aid. https://bit.ly/3ToNLwC. Accessed October 20, 2022. Duster C. How to qualify for Biden's new student loan forgiveness plan. CNN Politics. https://cnn.it/3ALjKjF. Published Wednesday August 24, 2022. Accessed August 24, 2022. Occupational Employment and Wages, May 2021 - Pharmacists. U.S. Bureau of Labor Statistics. https://bit.ly/3PObHXm. Published March 31, 2022. Accessed August 24, 2022. Smoot C. What is the average pharmacy school debt in 2022? SuperMoney. https://bit.ly/3PHqZNK. Published April 26, 2022. Accessed August 24, 2022.

Show notes at pharmacyjoe.com/episode757. In this episode, I'll discuss an article about the reversal of apixaban and rivaroxaban with andexanet alfa prior to invasive or surgical procedures. The post 757: Reversal of Apixaban and Rivaroxaban with Andexanet Alfa Prior to Invasive or Surgical Procedures appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode757. In this episode, I ll discuss an article about the reversal of apixaban and rivaroxaban with andexanet alfa prior to invasive or surgical procedures. The post 757: Reversal of Apixaban and Rivaroxaban with Andexanet Alfa Prior to Invasive or Surgical Procedures appeared first on Pharmacy Joe.

Pulmonary embolism, coffee, when DOACs don't work, lipoprotein (a), and the marginal benefits of current CV therapy are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Pulmonary Embolism - Positive Data on Thrombectomy Catheter That Avoids Thrombolytics in Acute PE https://www.medscape.com/viewarticle/981322 - Acute Outcomes for the Full US Cohort of the FLASH Mechanical Thrombectomy Registry in Pulmonary Embolism https://eurointervention.pcronline.com/article/acute-outcomes-for-the-full-us-cohort-of-the-flash-mechanical-thrombectomy-registry-in-pulmonary-embolism - PEERLESS Study https://clinicaltrials.gov/ct2/show/NCT05111613 - Ultrasound-facilitated, Catheter-directed, Thrombolysis in Intermediate-high Risk Pulmonary Embolism (HI-PEITHO) https://clinicaltrials.gov/ct2/show/NCT04790370 - A Prospective, Single-Arm, Multicenter Trial of Catheter-Directed Mechanical Thrombectomy for Intermediate-Risk Acute Pulmonary Embolism: The FLARE Study https://doi.org/10.1016/j.jcin.2018.12.022 II. Coffee Again - Coffee Linked to Reduced Cardiovascular Disease and Mortality https://www.medscape.com/viewarticle/981518 Enough With the Coffee Research and Other Distractions https://www.medscape.com/viewarticle/883709 - The impact of coffee subtypes on incident cardiovascular disease, arrhythmias, and mortality: long-term outcomes from the UK Biobank https://doi.org/10.1093/eurjpc/zwac189 III. DOAC and Mechanical Valves - PROACT Xa Trial of Apixaban With On-X Heart Valve Stopped https://www.medscape.com/viewarticle/981644 - Artivion Follows Recommendation to Stop PROACT Xa Clinical Trial https://investors.artivion.com/news-releases/news-release-details/artivion-follows-recommendation-stop-proact-xa-clinical-trial - PROACT Xa - A Trial to Determine if Participants With an On-X Aortic Valve Can be Maintained Safely on Apixaban https://clinicaltrials.gov/ct2/show/NCT04142658 - Dabigatran versus Warfarin in Patients with Mechanical Heart Valves https://www.nejm.org/doi/full/10.1056/nejmoa1300615 IV. Lipoprotein(a) - Aspirin Primary Prevention Benefit in Those With Raised Lp(a)? https://www.medscape.com/viewarticle/981602 - Aspirin for Primary Prevention of Cardiovascular Events in Relation to Lipoprotein(a) Genotypes https://www.jacc.org/doi/full/10.1016/j.jacc.2022.07.027 - A Randomized Trial of Low-Dose Aspirin in the Primary Prevention of Cardiovascular Disease in Women https://www.nejm.org/doi/full/10.1056/nejmoa050613 - Effect of Aspirin on Disability-free Survival in the Healthy Elderly https://www.nejm.org/doi/full/10.1056/NEJMoa1800722 - Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly https://www.nejm.org/doi/full/10.1056/NEJMoa1805819 - Effect of Aspirin on All-Cause Mortality in the Healthy Elderly https://www.nejm.org/doi/full/10.1056/NEJMoa1803955 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: news@medscape.net

This week on Pharm5 with special guests Karl Meyer and Shana Morrison: OTC oral contraceptive Post-surgical VTE prophylaxis with apixaban WHO fighting to end bacterial meningitis FDA approvals: Sotyktu, Rolvedon COVID vaccine decreases MIS-C risk Connect with us! Listen to our podcast: Pharm5 Watch us on TikTok: @LizHearnPharmD Follow us on Twitter: @LizHearnPharmD References Park B. FDA panel meeting scheduled to discuss RX-to-OTC switch of oral contraceptive opill. MPR. https://bit.ly/3BnOTZm. Published September 13, 2022. Accessed September 15, 2022. ASHP Policy week 2022. ASHP. https://bit.ly/3SbbeA2. Accessed September 15, 2022. Pharmacist-prescribed contraceptives. Guttmacher Institute. https://bit.ly/3Bn44Cg. Published August 24, 2022. Accessed September 15, 2022. Westerman ME, Bree KK, Msaouel P, et al. Apixaban vs enoxaparin for post-surgical extended-duration venous thromboembolic event prophylaxis: A prospective quality improvement study. Journal of Urology. 2022;208(4):886-895. doi:10.1097/ju.0000000000002788 Henderson Rby E. Oral anticoagulant drug may be safe, effective in preventing blood clots after Urologic Cancer surgery. News. https://bit.ly/3BJFlcA. Published September 13, 2022. Accessed September 15, 2022. Mutsaka F. Who launches drive to fight bacterial meningitis in Africa. AP NEWS. https://bit.ly/3BJETLl. Published September 8, 2022. Accessed September 14, 2022. Uhl R, Riga T. Spectrum Pharmaceuticals receives FDA approval for Rolvedon™ (eflapegrastim-xnst) injection. Spectrum Pharmaceuticals, Inc. https://bit.ly/3BiRowg. Published September 9, 2022. Accessed September 14, 2022. Dykes L. Deucravacitinib receives FDA approval for moderate-to-severe plaque psoriasis. Rheumatology Network. https://bit.ly/3eRss7m. Published September 10, 2022. Accessed September 14, 2022. Zambrano LD, Newhams MM, Olson SM, et al. BNT162B2 mrna vaccination against COVID-19 is associated with a decreased likelihood of multisystem inflammatory syndrome in children aged 5–18 years—United States, July 2021 – April 2022. Clinical Infectious Diseases. 2022. doi:10.1093/cid/ciac637

Show notes at pharmacyjoe.com/episode731. In this episode, I'll discuss a company-sponsored indirect comparative study looking at andexanet alfa vs 4 factor prothrombin complex concentrate (4FPCC) for the reversal of apixaban- or rivaroxaban-associated intracranial hemorrhage. The post 731: Company sponsored indrect comparison concludes the company’s product is better for the reversal of apixaban- or rivaroxaban-associated intracranial hemorrhage appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode731. In this episode, I ll discuss a company-sponsored indirect comparative study looking at andexanet alfa vs 4 factor prothrombin complex concentrate (4FPCC) for the reversal of apixaban- or rivaroxaban-associated intracranial hemorrhage. The post 731: Company sponsored indrect comparison concludes the company’s product is better for the reversal of apixaban- or rivaroxaban-associated intracranial hemorrhage appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode677. In this episode, I’ll discuss the efficacy tradeoff when reducing apixaban dose in patients with end-stage renal disease. The post 677: Is there an efficacy tradeoff when reducing apixaban dose in patients with end-stage renal disease? appeared first on Pharmacy Joe.