EFFICACY AND SAFETY OF APIXAN (APIXABAN) COMPARED WITH RIVAROXABAN IN COVID PATIENTS
| Autor: | Kazi Shamim Al Mamun, Anisul Awal, Md. Nur Uddin Tareq, Mohammad Ibrahim Chowdhury |
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| Rok vydání: | 2023 |
| Předmět: |
Cancer Research
Global and Planetary Change Ecology Sociology and Political Science Epidemiology Computer Networks and Communications Cognitive Neuroscience Religious studies Neuroscience (miscellaneous) Experimental and Cognitive Psychology Aquatic Science Sensory Systems Computer Science Applications Human-Computer Interaction Ophthalmology Philosophy Oncology Insect Science Animal Science and Zoology Computer Vision and Pattern Recognition Ecology Evolution Behavior and Systematics Nature and Landscape Conservation |
| Zdroj: | INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH. :82-85 |
| Popis: | Background: Increased risk of thromboembolic manifestations associated with COVID-19 shown in recent literature. Several hypotheses have been suggested to understand the underlying pathophysiology behind development of a prothrombotic state in COVID-19 such as exaggerated inammatory response resulting in activation of the coagulation cascade and endothelial injury. Methods And Materials: It was a prospective observational study, conducted in three tertiary care Private Hospitals of Chattogram City in Bangladesh. The study enrolled 253 consecutive outpatients from June 01, 2021 to May 31, 2022 due to Covid-19 disease on the basis of presentation of signs and symptoms severity. Upon admission, routine investigations, treatment and follow-up were carried out. Study population divided into two groups. In Apixan group, used only one brand drug tab. Apixan 5 mg twice daily and in Rivaroxaban group, used different brand of drugs 10 mg daily. Results: Mean age of the patients was 54.3±7.3 years. Between two groups, the predominant co-morbidity among patients was hypertension (74.0% vs 73.8%), followed by diabetes mellitus (53.5% vs 60.3%). Cough (95.2% vs 94.4%) was the most common symptom at presentation, followed by fever (86.6% vs 88.0%) and Fatigue (30.7% vs 30.2%), among cases of COVID patients. Maximum patients were mild illness 81.1 % vs 76.9% and severe cases 3.1% vs 7.1% which were statistically signicant (p=0.046). Patients Apixan group received more ACEi/ARB (74% vs 73.8%), antiplatelet (22% vs 20.6%) and Rivaroxaban group received more anti-diabetic (60.3% vs 53.5%), Beta Blocker (56.3% vs 50.3%). All event rates were numerically higher in the rivaroxaban group of COVID-19 patients compared with apixan group. In the unmatched analysis, hypoxia/ Oxygen used 9 cases of Apixan group compared with Rivaroxaban group 24 cases (7.1% vs 19%, p- 0.005), Lower limb swelling (DVT) (3.9% vs 11.1%, p- 0.03) and others bleeding events (16.5% vs 26.1%, p-0.047) which were signicant. In the term of primary outcome after propensity score matching (PSM), there were no signicant differences in the risks of all-cause mortality (0.8% vs 1.6%, p-0.62), muscle spasm (47.2% vs 46%, p-0.847), fatigue (37% vs 43.7%, p0.28) and hospital admission (6.3% vs 9.5%, p- 0.34). Likewise, there were no signicant differences in the risk of myocardial infarction (MI) between both groups (1.5% vs 2.3%, p-0.85) and major bleeding (ICH/GI bleeding) (1.6% vs 3.9%, p-0.42). The risk of suffering an ischemic stroke/TIAat 90-days after medication was higher in Rivaroxaban group (0.8% vs 6.3%, p-0.02) which was clinically signicant. Conclusion: In conclusion Rivaroxaban may be associated with an elevated bleeding risk and Apixan (Apixaban) may be associated with a lower bleeding risk with lower other events |
| Databáze: | OpenAIRE |
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