Current Venous Thromboembolism Management and Outcomes in Japan

Nakamura, Mashio; Miyata, Tetsuro; Ozeki, Yasushi; Takayama, Morimasa; Komori, Kimihiro; Yamada, Norikazu; Origasa, Hideki; Satokawa, Hirono; Maeda, Hitoshi; Tanabe, Nobuhiro; Unno, Naoki; Shibuya, Takashi; Tanemoto, Kazuo; Kondo, Kei; Kojima, Tetsuhito

doi:10.1253/circj.cj-13-0886

Cited by 112 publications

(84 citation statements)

References 20 publications

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“…2, 4 Anticoagulant therapy is currently recommended by the Japanese Circulation Society as the standard of care for PE and DVT, for which unfractionated heparin (UFH) or fondaparinux, and warfarin are used in Japan. 2 Dose adjustment, however, is a complicated matter when 2 drugs are used (warfarin with UFH or fondaparinux).…”

Section: Discussionmentioning

confidence: 99%

Apixaban for the Treatment of Japanese Subjects With Acute Venous Thromboembolism (AMPLIFY-J Study)

Nakamura

Nishikawa

Komuro

et al. 2015

Circ J

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Background: Anticoagulation is recommended as standard of care for venous thromboembolism (VTE) (pulmonary embolism [PE]/deep vein thrombosis [DVT]), for which unfractionated heparin (UFH) and warfarin are used in Japan. In the multi-regional AMPLIFY study, a fixed-dose regimen of apixaban alone was non-inferior to conventional therapy for treatment of PE/DVT and was associated with significantly fewer bleeding events. Methods and Results:Japan phase 3 study (AMPLIFY-J), randomized, active-controlled, open-label study in Japanese subjects with acute PE/DVT, was designed based on AMPLIFY. Key objectives were to investigate safety and efficacy of apixaban in symptomatic PE/DVT subjects during 24-week treatment. UFH/warfarin was used as control treatment. Apixaban was initiated at 10 mg twice daily for 7 days, followed by 5 mg twice daily for 23 weeks. All endpoints and imaging for thrombotic burden were assessed by an event adjudication committee. Eighty subjects were randomized, 33 subjects (41.3%) were aged <65 years. Proportion of major/clinically relevant non-major bleeding was lower in apixaban (7.5%) compared with well-controlled UFH/warfarin (28.2%; median TTR, 70.1%). Recurrent VTE occurred in no subjects in apixaban and in 1 subject in UFH/warfarin. Thrombotic burden results were similar in both groups. Proportions of subjects with adverse events was generally similar in both groups. Conclusions:Apixaban was well-tolerated and had a favorable safety profile. No clinically important efficacy difference compared with UFH/warfarin was observed. (Circ J 2015; 79: 1230 -1236

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Section: Discussionmentioning

confidence: 99%

Apixaban for the Treatment of Japanese Subjects With Acute Venous Thromboembolism (AMPLIFY-J Study)

Nakamura

Nishikawa

Komuro

et al. 2015

Circ J

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“…In contrast, the Japanese guidelines recognize that thrombolysis is indicated for a wider range of diseases and that thrombolysis can be considered for patients with shock, those with unstable hemodynamics, and those with right heart strain Grade 2A 1 . Thus, the frequency of thrombolysis in patients with pulmonary embolism in Japan is higher than that in Europe and the US 23 embolism was associated with a decreased risk of all-cause mortality, but with increased risks of major bleeding and intracerebral hemorrhage 25 . Thus, there is still no de nitive conclusion about whether thrombolysis is indicated for acute pulmonary embolism, and further studies are needed to evaluate its indications.…”

Section: Discussionmentioning

confidence: 99%

Serum Soluble Thrombomodulin Level on Admission Is a Useful Predictor of Treatment Response in Patients with Acute Pulmonary Thromboembolism

:筆頭著者

Miyake

et al. 2017

Showa Univ J Med Sci

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: Previous studies have reported elevated serum soluble thrombomodulin sTM concentrations in acute pulmonary thromboembolism APTE , but no study has evaluated the relationship between the serum sTM concentration and prognosis. In the present study we investigated the correlation between the serum sTM concentration on admission and the duration of oxygen supplementation in patients admitted to the coronary care unit CCU for APTE to evaluate whether serum sTM is a useful predictor of treatment response. The study included 38 consecutive patients 14 men, 24 women ; mean SD age 59.9 16.8 years admitted to the CCU between March 2012 and July 2014 with a diagnosis of APTE con rmed by contrast-enhanced computed tomography within 7 days of onset. The severity of pulmonary embolism was classi ed as collapse and cardiac arrest type in three patients 8 , massive type in two 5 , submassive type in 19 50 , and nonmassive type in 14 38 . Signi cant positive correlations were found for both age and creatinine clearance with duration of hospitalization, but not with duration of oxygen supplementation. There was a signi cant positive correlation between admission sTM concentrations and both days of hospitalization R 0.57, P 0.005 and duration of oxygen supplementation R 0.56, P 0.01 . The ndings of the present study suggest that serum sTM concentrations are promising predictors of treatment response and short-term prognosis in patients with APTE.

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“…Case-fatality of PE during treatment 0.015 0.0091-0.0209 [32] Case-fatality of PE asymptomatic 0.270 0.164-0.376 [33] Case-fatality of PE immediately 0.220 0.134-0.306 [33] Case-fatality of DVT (proximal or distal) during treatment 0.004 0.0024-0.0056 [32] Annual probability of recurrent VTE Year 1-2 0.081 0.049-0.113 [21] Year 3-5 0.029 0.018-0.041 [22] treated with rivaroxaban or apixaban versus enoxaparin [20]. In the Markov process, patients with a VTE history might suffer a recurrent VTE and develop post-PTS (in patients who suffered a DVT) or CTEPH (in patients who suffered a PE).…”

Section: Clinical Inputsmentioning

confidence: 99%

Cost–Effectiveness of Different Strategies for Prevention of Venous Thromboembolism after Total Hip Replacement in China

Yan

Zhou

et al. 2016

Value in Health

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Current Venous Thromboembolism Management and Outcomes in Japan

Cited by 112 publications

References 20 publications

Apixaban for the Treatment of Japanese Subjects With Acute Venous Thromboembolism (AMPLIFY-J Study)

Apixaban for the Treatment of Japanese Subjects With Acute Venous Thromboembolism (AMPLIFY-J Study)

Serum Soluble Thrombomodulin Level on Admission Is a Useful Predictor of Treatment Response in Patients with Acute Pulmonary Thromboembolism

Cost–Effectiveness of Different Strategies for Prevention of Venous Thromboembolism after Total Hip Replacement in China

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