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Long term thérapy for PE of VTE

Long term thérapy for PE of VTE. C Becattini for the WARFASA study. Randomisée TVP sans cause retrouvée De 6 à 18 mois de TTT.

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Long term thérapy for PE of VTE

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  1. Long term thérapy for PE of VTE

  2. C Becattini for the WARFASA study Randomisée TVP sans cause retrouvée De 6 à 18 mois de TTT

  3. Venous thromboembolism recurred in 28 of the 205 patients who received aspirin and in 43 of the 197 patients who received placebo (6.6% vs. 11.2% per year; hazard ratio, 0.58; 95% confidence interval [CI], 0.36 to 0.93)

  4. Schulman S et al RE-Medy and Re-Sonate trials Dabigatran 150 mg*2, Warfarine, Placébo Patient 3 mois après traitement initial pour VTE Randomisation 1/1 Dabigatran vs Placébo Randomisation 1/1 Dabigatran vs Warfarine (double insu; INR fictif) Recrutement spontané ou à partir des études RECOVER et RECOVER II Echo Doppler à 72 h de la rando Critères de jugement: Récidive clinique, saignements 2013;368:709-18

  5. Any bleeding at 1 year: Dabigatran 15%; Warfarin 20% Major Bleeding: Dabigatran: 5,6% Warfarin: 10,2%

  6. Apixaban 2,5 ou 5mg (2 XJ) vs placébo Randomisée en 1/1/1 Récurrence clinique de TVP ou EP Bleeding: Hb baisse de 2g/l ou transfusion Prétraitement par AC 6 à 12 mois 8 dec 2012

  7. Major Bleeding at 1 year: Apixaban 2,5*2 : 3%

  8. TVP ou EP sans facteur de risque majeur • Récidive de TVP ou EP peut être estimée à 10% par an lors des premières années • Effet positif de l’aspirine sur la récidive de TVP • Dabigatran à 150 mg*2 non inférieur à Warfarine. Taux moyen de récidive: 1% à 12 mois. • Effet significatif de l’apixaban 2,5 X 2 , sans sur-risque de saignement majeur. • Durée du Traitement ???

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