Safety, efficiency and cost effectiveness of Bivalirudin: A systematic review

Abstract

AIMTo review the early and more recent studies of Bivalirudin, to assess the safety, effectiveness, and cost benefits of this drug.METHODSLiterature search of MEDLINE and PubMed databases from 1990 to 2017 using keywords as “bivalirubin” and “angiomax”, combined with the words “safety”, “effectiveness”, “efficiency”, “side effects”, “toxicity”, “adverse effect”, and “adverse drug reaction”.RESULTSA total of 66 publications were reviewed. The changes in clinical practice and differences in clinical protocols make it difficult to do direct comparisons of studies among each other. However, most trials showed decreased bleeding complications with bivalirudin, although ischemic complications and mortality were mostly comparable, with some favor towards bivalirudin.CONCLUSIONBivalirudin and heparin are both acceptable options according to current ACA/AHA guidelines. Authors conclude however, that that due to bivalirudin safer bleeding profile, it should be the preferred medication for anticoagulation.

Magnetic coagulometry: towards a new nanotechnological tool for ex vivo monitoring coagulation in human whole blood

“… 38 To assess whether AC magnetic susceptibility can track the effect of these drugs in blood coagulation, measurements of the out-of-component signal of AC magnetic susceptibility were performed ex vivo in freshly donated human whole blood samples. Following guidelines of clinical doses for rivaroxaban 39 and bivalirudin, 40 IONPs-labelled blood samples were pre-treated with either 20, 100 and 200 ng mL −1 of rivaroxaban ( Fig. 5 ) or 2, 10 and 20 μg mL −1 of bivalirudin ( Fig.…”

Individual Patient Data Pooled Analysis of Randomized Trials of Bivalirudin versus Heparin in Acute Myocardial Infarction: Rationale and Methodology

“…such as use of femoral or radial access; the dose of heparin used; adjunct medication use such as prerandomization heparin use, unplanned versus planned GPI, and P2Y12 receptor inhibitor potency; and the use of dosing and duration of a bivalirudin post-PCI infusion. Even though numerous study-level systematic reviews and meta-analyses have been published, 4,12,13,49 none has clearly identified subgroups that may particularly benefit from a bivalirudinbased or a heparin-based regimen. Such studies are also unable to account for heterogeneity in endpoint measures, adjust for confounders, or examine the temporal relationships in outcomes.…”

From Animal Poisons and Venoms to Medicines: Achievements, Challenges and Perspectives in Drug Discovery

“…Angiomax ® was approved by the FDA in 2000 to patients with unstable angina undergoing percutaneous transluminal coronary angioplasty (Bittl et al, 2001). In Europe it is marketed as Angiox ® (Mehrzad et al, 2017).…”