Evidence map›Paper›PMID 35683593›Full record

ArticleJournal of clinical medicine2022

Five Years of Direct Oral Anticoagulants Use in Italy: Adverse Drug Reactions from the Italian National Pharmacovigilance Network.

Carlo Lavalle, Marco Valerio Mariani, Agostino Piro, Michele Magnocavallo, Giampaolo Vetta, Sara Trivigno, Giovanni Battista Forleo, Domenico Giovanni Della Rocca, Massimo Uguccioni, Vincenzo Russo and 2 more

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 6 institutions in 2 countries.

Carlo LavalleDepartment of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
Marco Valerio MarianiDepartment of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.ORCID 0000-0002-9480-1209
Agostino PiroDepartment of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
Michele MagnocavalloDepartment of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
Giampaolo VettaDepartment of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.ORCID 0000-0002-1120-0492
Sara TrivignoDepartment of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
Giovanni Battista ForleoDepartment of Cardiology, ASST-Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, 20157 Milan, Italy.ORCID 0000-0001-8895-8915
Domenico Giovanni Della RoccaTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705, USA.ORCID 0000-0003-3837-3462
Massimo UguccioniUPMC Salvator Mundi, 00152 Rome, Italy.
Vincenzo RussoDepartment of Medical Transational Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital, 80131 Naples, Italy.ORCID 0000-0002-9227-0360
Francesco SummariaUOC Cardiologia, Ospedale San Eugenio, 00144 Rome, Italy.ORCID 0000-0002-1355-9773
Luca Di LulloDepartment of Nephrology and Dialysis, L. Parodi-Delfino Hospital, Piazza Aldo Moro 1, 00034 Rome, Italy.
Sapienza University of Rome · ITCTO Hospital · ITSt David's Medical Center · USSt. Eugenio Hospital · ITUniversity of Campania "Luigi Vanvitelli" · ITUniversity of Milan · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDirect oral anticoagulants (DOACs) are the preferred anticoagulant drugs for the prevention of atrial fibrillation (AF)-related thromboembolic complications and for the treatment and the prevention of recurrences of venous thromboembolism (VTE). The evaluation of self-reported adverse drug reactions (ADRs) available from databases of drug-regulatory agencies such as the Italian Medicines Agency (AIFA) pharmacovigilance database represents a novel aid to guide decision making.

objectiveTo assess the safety profile of DOACs by analyzing ADR rates in the real-world Italian scenario.

methodsPost-marketing surveillance data recorded by the National Pharmacovigilance Network were retrieved for the time period 2017-2021 from the AIFA online site. The following data were collected for each DOAC: total ADR number, serious ADR number, gastrointestinal (GI) ADR, intracranial hemorrhage events (ICH ADR), and more frequently reported ADR for the study year. The safety profile was expressed by the risk index (RI).

resultsRivaroxaban use was associated with consistent and stable low rates of serious ADR, GI ADR, and ICH ADR across the 5-year study period. Rivaroxaban and apixaban showed the lowest RI for serious ADR and GI ADR, while rivaroxaban use was associated with significantly lower ICH events as compared to apixaban. Dabigatran was related to the highest RIs for every ADR class, in particular GI ADRs.

conclusionsDOACs presented an acceptable safety profile in the current post-market analysis. However, rivaroxaban and apixaban were associated with more favorable safety profiles as compared to dabigatran, while rivaroxaban provoked statistically significantly fewer ICH events as compared to apixaban.

Indexed as

adverse drug reactionanticoagulantsatrial fibrillationDOAC

Identifiers

PMID35683593
PMCPMC9181424
OpenAlexW4282002709

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.