Pradaxa-induced esophageal ulcer

Wood, Michele; Shaw, P.W.

doi:10.1136/bcr-2015-211371

Cited by 11 publications

(9 citation statements)

References 7 publications

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“…In a cytotoxicity study, although the study design and test concentrations of dabigatran were different from our study, no cytotoxic effect was shown with dabigatran and degradation products (24). In a real-life setting and clinical practice, mid-esophageal ulcer was reported in some of the patients using dabigatran, suggesting that dabigatran has a direct caustic effect on capsular formation (25,26). In the present study, although warfarin showed similar fi broblastic morphology with the control group, except for dilution I, cell viability was found to be statistically signifi cantly lower in all dilutions, compared to the control group.…”

Section: Assessment Of Cell Viabilitycontrasting

confidence: 69%

A link between cytotoxicity in cell culture and gastrointestinal side effects of oral anticoagulants: bench-to-bedside

Kubat¹,

Gürpınar²,

Karasoy³

et al. 2018

BLL

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OBJECTIVE: Warfarin and nonvitamin-K oral anticoagulants including dabigatran, rivaroxaban, and apixaban are commonly used in the prophylaxis and treatment of systemic embolism and deep vein thrombosis. In this study, we aimed to compare the cytotoxic effects of warfarin and new oral anticoagulants and to show a possible correlation between cell cytotoxicity and gastrointestinal side effects in the real-life setting. METHODS: L929 cells were incubated with test materials. At 24 and 48 hours, morphological changes and cell viability were evaluated. RESULTS: At 24 and 48 hours, dabigatran resulted in altered cell morphology in all dilutions, while rivaroxaban, apixaban, and warfarin showed similar morphology with the control group, except for dilution I. Dabigatran and warfarin at 24 hours and at 48 hours had a statistically signifi cantly lower cell viability in all dilutions, compared to the control group. CONCLUSION: Gastrointestinal side effect profi les of these four agents in a real-life setting is consistent with the results obtained from the present study. There is no sole factor with the potential of explaining the entire gastrointestinal side effect profi les of anticoagulant agents. However, direct cytotoxic effects of anticoagulants should be considered primarily for gastrointestinal side effects in accordance with the results of present headto-head cytotoxicity study (Tab.

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Section: Assessment Of Cell Viabilitycontrasting

confidence: 69%

A link between cytotoxicity in cell culture and gastrointestinal side effects of oral anticoagulants: bench-to-bedside

Kubat¹,

Gürpınar²,

Karasoy³

et al. 2018

BLL

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“…Furthermore, an acidifying agent was added to the reference formulation to acidify the solid‐liquid interface and surrounding microenvironment, maintaining a favorable pH condition, improving the apparent solubility, intestinal dissolution of the drug, and ultimately favoring intraluminal supersaturation, which may improve intestinal absorption. The caveat of using acidifying agents is to cause esophageal ulcer and dyspepsia 5,37,38 …”

Section: Discussionmentioning

confidence: 99%

“…The caveat of using acidifying agents is to cause esophageal ulcer and dyspepsia. 5,37,38 In this research, PSAs were performed on both CSR and PRC as substitute of presence and absence of acidifying and enteric coating agents, respectively. CSR is the ratio between maximum solubility attainable kinetically (critical supersaturation concentration [CSC]) and equilibrium solubility (S eq ).…”

Section: Dabe Dosing Regimenmentioning

confidence: 99%

Physiologically‐based pharmacokinetics modeling to investigate formulation factors influencing the generic substitution of dabigatran etexilate

Farhan

Cristofoletti

Basu

et al. 2021

CPT Pharmacom & Syst Pharma

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“…The rate of esophageal bleeding was significantly higher in the antithrombotic group (12/99, 12.1% versus 6/131, 4.6%) for Bezold-Jarisch reflection (induced by hypovolemia and myocardial ischemia during or after cardiac surgery and percutaneous coronary intervention) [10,11]. In addition, antithrombotic drugs reportedly induce esophageal ulcers (taking antithrombotic drugs in the recumbent position and/or insufficient water consumption, leading to drug retention and damage to the esophagus) [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Acute Nonvariceal Upper Gastrointestinal Bleeding in Chinese Patients on Antithrombotic Therapy

Gao

Xue

Zhang

2019

Gastroenterology Research and Practice

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Objective. To assess the treatment of acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) in Chinese patients on antithrombotic therapy. Methods. The clinical data of patients with ANVUGIB who underwent upper gastrointestinal endoscopy 24 h after bleeding at Beijing Anzhen Hospital, Capital Medical University, from 2016 to 2018, were analyzed retrospectively. The patients were divided into antithrombotic therapy and control groups and into high-risk (Forrest Ia, Ib, IIa, and IIb) and low-risk (Forrest IIc and III) bleeding groups according to the results of endoscopy. Results. In all, 230 patients were enrolled, with 99 cases in the antithrombotic group (antiplatelet therapy 80 patients, anticoagulant therapy 19 patients) and 131 cases in the control group (without antithrombotic therapy). A total of 78 and 21 and 84 and 47 patients were at high- and low- risk for bleeding (P=0.019) in the antithrombotic and control groups, respectively; 12.1% and 4.6% had esophageal bleeding (P=0.047), and 8 and 2 patients received interventional therapy (P=0.021). Overall, 21 patients with hemodynamic instability were treated via endoscopy with anesthesia under tracheal intubation and ventilator support: 20 patients in the antithrombotic group (13 patients within 1 month after coronary intervention, 5 patients within 1 month of cardiac-valve replacement, and 2 patients within 4 years of cardiac-valve replacement) and 1 patient with third-degree atrioventricular block in the control group. Ten patients received interventional therapy: eight and two in the two groups, respectively. Multidisciplinary consultation was conducted to regulate the use of antithrombotic drugs. Conclusion. Compared to the controls, patients in the antithrombotic group had a significantly higher incidence of critical and active bleeding. Patients with hemodynamic instability should be examined and treated via upper gastrointestinal endoscopy under anesthesia with tracheal intubation and ventilator support.

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Pradaxa-induced esophageal ulcer

Cited by 11 publications

References 7 publications

A link between cytotoxicity in cell culture and gastrointestinal side effects of oral anticoagulants: bench-to-bedside

A link between cytotoxicity in cell culture and gastrointestinal side effects of oral anticoagulants: bench-to-bedside

Physiologically‐based pharmacokinetics modeling to investigate formulation factors influencing the generic substitution of dabigatran etexilate

Treatment of Acute Nonvariceal Upper Gastrointestinal Bleeding in Chinese Patients on Antithrombotic Therapy

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