На ESC представлены результаты OASIS -5.
Новый антитромботический агент (ингибитор Xa фактора) становится по рез-там исследования средством выбора для лечения OКС без подьема ST. главная фишка :почти в два раза меньше кровотечений при использовании фондапаринукса (один раз в сутки!, независимо от массы тела!) в сравнении с эноксапарином, интересно было бы узнать мнение коллег. Более полная инфа на [
Ссылки доступны только зарегистрированным пользователям ], (думаю , что размещать здесь таблицы с энд пойнтами с
P,< 0,05 - чистейший флуд)))
Stockholm, Sweden -
Fondaparinux, the new anti-Xa inhibitor, is as effective as enoxaparin in reducing cardiovascular events in the short term, while causing half the amount of bleeding, according to results of OASIS-5/Michaelangelo, the largest ACS trial conducted to date.
By 30 days this benefit in bleeding had translated into a significant reduction in mortality, Dr Salim Yusuf (McMaster University, Hamilton, ON) told the European Society of Cardiology (ESC) Congress 2005 today, These results, according to Yusuf, should lead to fondaparinux becoming the new preferred antithrombotic drug used in ACS patients
"We have shown that bleeding causes death, and we have shown a striking reduction in bleeding. This was shown in all subgroups there was no subgroup in which enoxaparin looked better," Yusuf said. The benefit of fondaparinux was seen both in hospitals with cath labs and those without and was irrespective of whether patients received unfractionated heparin at any time either before or after randomization, he reported. "Fondaparinux will reduce bleeding irrespective of the type of hospital you practice in or, in contrast to SYNERGY, whether you switch antithrombotic therapy," he commented.
Noting that the price of fondaparinux is currently around 70% that of enoxaparin, he added: "This new drug therefore has a net clinical benefit at no greater financial cost." Yusuf calculated that treating 1000 ACS patients with fondaparinux instead of enoxaparin would prevent 10 deaths, four strokes, and 25 major bleeds.
Co-lead investigator Dr Shamir Mehta (McMaster University, Hamilton, ON) commented to heartwire: "Fondaparinux had a net clinical benefit in both the conservative medical approach and in the aggressive interventional approach. Everyone will be happy with this drug noninterventional cardiologists, interventional cardiologists, and hospital administrators. There is no doubt in my mind that this drug is preferable to enoxaparin. Physicians will have to think twice or thrice before prescribing enoxaparin after seeing these reductions in bleeding and mortality with fondaparinux."
Discussant of the trial at the ESC hotline session, Dr Robert Califf (Duke University, Durham, NC) said that fondaparinux was an "excellent regimen" and appeared to have a unique profile as an antithrombotic drug. He explained that while all previous antithrombotics have a trade-off, with both efficacy and bleeding increasing as the dose increases, fondaparinux appears to have a dose-related effect on bleeding but not on efficacy, so the lowest dose is the most effective one. "This is a great situation that we have previously only dreamed about," he commented.