topics / مواضيع: BACKGROUND: Direct oral anticoagulants (DOACs) are becoming the medication of choice for the management of venous

BACKGROUND: Direct oral anticoagulants (DOACs) are becoming the medication of choice for the management of venous

Abstract

BACKGROUND: Direct oral anticoagulants (DOACs) are becoming the medication of choice for the management of venous thromboembolism and stroke prevention in atrial fibrillation because of simplified dosing, a more predictive pharmacokinetic profile, and better clinical outcomes when compared with traditional vitamin K antagonists. Recently, reversal agents for DOACs have been approved by the U.S. Food and Drug Administration for use in managing life-threatening or uncontrolled bleeding; however, for acute nonhemorrhagic conditions requiring surgical intervention, such as acute hydrocephalus requiring ventriculostomy, there is little evidence to help guide appropriate management for patients on DOACs.

CASE DESCRIPTION: We report the use of andexanet alfa to counteract rivaroxaban treatment in a 28-year-old woman who developed herniation syndrome and acute hydrocephalus from a cerebellar tumor.

CONCLUSIONS: We describe how appropriate timing of administration of the DOAC reversal agent may permit urgent neurosurgical intervention.

PMID: 31809896 [PubMed - indexed for MEDLINE]

25 March 2020

11:42

Cancer & Heart (Cardio-Oncology, Cardiotoxicity, TEV)

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pubmed: ctoall&ca or conall

The Emerging Discipline of Cardio-Oncology; What, why and how?

J Pak Med Assoc. 2020 Mar;70(3):567-568

Authors: Ahmed Naqvi SA, Hasan Zaidi SD, Haider MZ

PMID: 32207454 [PubMed - in process]

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A phase 2 study to assess the pharmacokinetics and pharmacodynamics of CPX-351 and its effects on cardiac repolarization in patients with acute leukemias.

//www.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--production.springer.de-OnlineResources-Logos-springerlink.gif //www.ncbi.nlm.nih.gov/corehtml/query/egifs/https:--www.ncbi.nlm.nih.gov-corehtml-pmc-pmcgifs-pubmed-pmc.png Related Articles

A phase 2 study to assess the pharmacokinetics and pharmacodynamics of CPX-351 and its effects on cardiac repolarization in patients with acute leukemias.

Cancer Chemother Pharmacol. 2019 07;84(1):163-173

Authors: Lin TL, Newell LF, Stuart RK, Michaelis LC, Rubenstein E, Pentikis HS, Callahan T, Alvarez D, Liboiron BD, Mayer LD, Wang Q, Banerjee K, Louie AC

Abstract

PURPOSE: Daunorubicin can induce left ventricular dysfunction and QT interval prolongation. This study assessed the effects of CPX-351, a liposomal encapsulation of cytarabine and daunorubicin, on cardiac repolarization.

METHODS: Twenty-six adults with acute leukemia were treated with CPX-351 for 1-2 induction cycles and ≤ 4 consolidation cycles. The primary endpoint was mean change in QTcF from baseline.

RESULTS: Mean QTcF changes were < 10 ms30 h. Thirteen (50%) patients achieved remission. The most common adverse events were febrile neutropenia, fatigue, and nausea.

CONCLUSIONS: The cytarabine and daunorubicin in CPX-351 liposomes were metabolized and excreted similarly to conventional formulation; however, plasma pharmacokinetics were altered. CPX-351 did not prolong the QT interval, suggesting that CPX-351 may induce less cardiotoxicity than previously reported for conventional daunorubicin.

TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT02238925.

PMID: 31098682 [PubMed - indexed for MEDLINE]

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Cancer & Heart (Cardio-Oncology, Cardiotoxicity, TEV)

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pubmed: caandvteortroorpul

Nationwide in-hospital mortality rate following rectal resection for rectal cancer according to annual hospital volume in Germany.

BJS Open. 2020 Apr;4(2):310-319