medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2016-10-112-118medsovet-1413Research ArticleФЛЕБОЛОГИЯPHLEBOLOGYПродленная терапия венозного тромбоза оральными антикоагулянтами. Фокус на безопасностьEXTENDED THERAPY OF VENOUS THROMBOSIS BY ORAL ANTICOAGULANTS: FOCUS AT SAFETYСЧАСТЛИВЦЕВИ. В.SCHASTLIVTSEVI. V.

к.м.н.

Москва

PhD in medicine

ЛОБАСТОВК. В.LOBASTOVK. V.

к.м.н.

Москва

PhD in medicine

БАРИНОВВ. Е.BARINOVV. E.

д.м.н., профессор

Москва

MD, Prof.

ЦАПЛИНС. Н.TSAPLINS. N.

к.м.н.

Москва

PhD in medicine

ВОРОНЦОВАА. В.VORONTSOVAA. V.

Москва

ЛАБЕРКОЛ. А.LABERKOL. A.

д.м.н., профессор

Москва

MD, Prof.

РОДОМАНГ. В.RODOMANG. V.

д.м.н., профессор

Москва

MD, Prof.

БОЯРИНЦЕВВ. В.BOYARINTSEVV. V.

д.м.н., профессор

Москва

MD, Prof.

Российский национальный исследовательский медицинский университет им. Н.И. Пирогова; Клиническая больница №1 (Волынская) Управления делами Президента РФРоссияSBEI HPE Pirogov Russian National Research Medical University; FSBI Clinical Hospital No.1 (Volynskaya) of the RF President Affairs ManagementRussian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияSBEI HPE Pirogov Russian National Research Medical UniversityRussian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. Пирогова; Городская клиническая больница №24 Департамента здравоохранения г. МосквыРоссияSBEI HPE Pirogov Russian National Research Medical University; Municipal Clinical Hospital No. 24 of Healthcare Department of MoscowRussian FederationКлиническая больница №1 (Волынская) Управления делами Президента РФРоссияFSBI Clinical Hospital No.1 (Volynskaya) of the RF President Affairs ManagementRussian Federation201630122016010112118Copyright © СЧАСТЛИВЦЕВ И.В., ЛОБАСТОВ К.В., БАРИНОВ В.Е., ЦАПЛИН С.Н., ВОРОНЦОВА А.В., ЛАБЕРКО Л.А., РОДОМАН Г.В., БОЯРИНЦЕВ В.В., 20162016СЧАСТЛИВЦЕВ И.В., ЛОБАСТОВ К.В., БАРИНОВ В.Е., ЦАПЛИН С.Н., ВОРОНЦОВА А.В., ЛАБЕРКО Л.А., РОДОМАН Г.В., БОЯРИНЦЕВ В.В.SCHASTLIVTSEV I.V., LOBASTOV K.V., BARINOV V.E., TSAPLIN S.N., VORONTSOVA A.V., LABERKO L.A., RODOMAN G.V., BOYARINTSEV V.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/1413

Цель исследования: оценить безопасность пролонгированной терапии венозного тромбоза ривароксабаном в сравнении со стандартной схемой лечения низкомолекулярными гепаринами (НМГ) с последующим переходом на прием варфарина. Материал и методы: проведено проспективное наблюдательное сравнительное исследование, включившее 243 пациента с верифицированным венозным тромбозом. Контрольную группу составили 96 пациентов, которым была назначена терапия НМГ/варфарин. В основную группу было включено 147 пациентов, которым назначался ривароксабан. Результаты: частота больших кровотечений составила 0% в основной группе против 2% в контрольной группе (р = 0,32). Общая частота развития геморрагических осложнений оказалась равна 10,2% в основной группе и 12,5% в контрольной (p = 0,73). После развития геморрагического осложнения антикоагулянтную терапию продолжили 86,7% пациентов основной группы и только 50% контрольной группы (р = 0,049). Выводы: полученные нами результаты подтверждают более высокую безопасность использования ривароксабана по сравнению с варфарином в рамках продленной терапии венозного тромбоза. Эти данные согласуются с ранее опубликованными результатами исследований EINSTEIN и XALIA. 

Study objective: to evaluate safety of prolonged therapy of venous thrombosis by rivarixaban compared to the standard scheme of therapy by low-molecular heparins (LMH) with subsequent transfer to warfarin administration. Materials and methods. Prospective observation comparative study was conducted that included 243 patients with verified venous thrombosis. The control group included 96 patients to whom therapy by LMH/warfarin was prescribed. The major group included 147 patients to whom rivaroxaban was prescribed. Results. The frequency of major hemorrhages reached 0% in the major group versus 2% in the control group (р = 0.32). The total frequency of hemorrhagic complications development amounted to 10.2% in the major group and 12.5% in the control one (p = 0.73). 86.7% of patients of the major group and only 50% of the control group (р = 0.049) continued the anticoagulant therapy after development of hemorrhagic complications. Conclusions: the results obtained by us confirm higher safety of rovaroxaban use compared to warfarin within prolonged therapy of venous thrombosis. These data correspond to the results of the previously published studies EINSTEIN and XALIA.

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The authors declare that there are no conflicts of interest present.