AboutContactsEditorial StaffEditorial CouncilArchiveFor AuthorsFor Reviewers

Recommendations on the use of oral anticoagulants in elderly patients: Beers criteria and evidence-based medicine

Journal «MEDICINA» ¹ 4, 2019, pp.1-11 (Research)

Authors

Bel'diev S. N.
PhD, Associate Professor, Chair for Therapy and Cardiology1

Egorova I. V.
PhD, Assistant, Chair for Therapy and Cardiology1

Platonov D. Ju.
Doctor of Medicine, Head, Chair for Therapy and Cardiology1

1 - Tver State Medical University, Tver, Russia

Corresponding Author

Bel'diev Sergej; e-mail: sbeldiev@yandex.ru

Conflict of interest

None declared.

Funding

The study had no sponsorship.

Abstract

The article presents a critical analysis of recommendations on oral anticoagulants use, cited (with reference to the Beers criteria) in the 2018 Russian expert opinion «Features of diagnosis and treatment of chronic heart failure in elderly and senile patients».

Key words

dabigatran, rivaroxaban, apixaban, edoxaban, elderly, Beers criteria

DOI

References

1. Orlova I.A., Tkacheva O.N., Arutyunov G.P., Kotovskaya Y.V., Vasjuk Y.A., Lopatin Y.M., et al. Osobennosti diagnostiki i lecheniya hronicheskoj serdechnoj nedostatochnosti u pacientov pozhilogo i starcheskogo vozrasta. Mnenie ekspertov Obshchestva specialistov po serdechnoj nedostatochnosti, Rossijskoj associacii gerontologov i geriatrov i Evrazijskoj associacii terapevtov [Features of diagnostics and treatment of chronic heart failure in elderly and senile patients. Expert opinion of the Society of Experts in Heart Failure, Russian Association of Gerontologists, and Eurasian Association of Therapists]. Kardiologiia [Cardiology] 2018; 58(12S): 42-72. doi: 10.18087/cardio.2560. (In Russ.).

2. American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. By the American Geriatrics Society 2015 Beers Criteria Update Expert Panel. J Am Geriatr Soc 2015; 63(11): 2227-2246. doi: 10.1111/jgs.13702.

3. American Geriatrics Society Updated Beers Criteria for potentially Inappropriate Medication Use in Older Adults. The American Geriatrics Society 2012 Beers Criteria Update Expert Panel. J Am Geriatr Soc 2012; 60(4): 616-631. doi: 10.1111/j.1532-5415.2012.03923.x.

4. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. J Am Geriatr Soc 2019; 67(4): 674-694. doi: 10.1111/jgs.15767.

5. Steinman M.A., Fick D.M. Using wisely: a reminder on the proper use of the American Geriatrics Society Beers Criteria®. J Am Geriatr Soc 2019; 67(4): 644-646. doi: 10.1111/jgs.15766.

6. Zhu J., Alexander G.C., Nazarian S., Segal J.B., Wu A.W. Trends and variation in oral anticoagulant choice in patients with atrial fibrillation, 2010-2017. Pharmacotherapy 2018; 38(9): 907-920. doi: 10.1002/phar.2158.

7. Eikelboom J.W., Wallentin L., Connolly S.J., Ezekowitz M., Healey J.S., Oldgren J. et al. Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial. Circulation 2011; 123(21): 2363-2372. doi: 10.1161/CIRCULATIONAHA.110.004747.

8. Halperin J.L., Hankey G.J., Wojdyla D.M., Piccini J.P., Lokhnygina Y., Patel M.R. et al. Efficacy and safety of rivaroxaban compared with warfarin among elderly patients with nonvalvular atrial fibrillation in the Rivaroxaban Once Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF). Circulation 2014; 130(2): 138-146. doi: 10.1161/CIRCULATIONAHA.113.005008.

9. Kato E.T., Giugliano R.P., Ruff C.T., Koretsune Y., Yamashita T., Kiss R.G. et al. Efficacy and safety of edoxaban in elderly patients with atrial fibrillation in the ENGAGE AF-TIMI 48 trial. J Am Heart Assoc 2016; 5(5): e003432. doi: 10.1161/JAHA.116.003432.

10. Halvorsen S., Atar D., Yang H., De Caterina R., Erol C., Garcia D. et al. Efficacy and safety of apixaban compared with warfarin according to age for stroke prevention in atrial fibrillation: observations from the ARISTOTLE trial. Eur Heart J 2014; 35(28): 1864-1872. doi: 10.1093/eurheartj/ehu046.

11. Mareev V.Y., Fomin I.V., Ageev F.T., Begrambekova Y.L., Vasyuk Y.A., Garganeeva A.A. et al. Klinicheskie rekomendacii OSSN – RKO – RNMOT. Serdechnaya nedostatochnost': hronicheskaya (HSN) i ostraya dekompensirovannaya (ODSN). Diagnostika, profilaktika i lechenie [Russian Heart Failure Society, Russian Society of Cardiology. Russian Scientific Medical Society of Internal Medicine Guidelines for Heart failure: chronic (CHF) and acute decompensated (ADHF). Diagnosis, prevention and treatment]. Kardiologiia [Cardiology] 2018; 58(6S): 8-158. doi: 10.18087/cardio.2475. (In Russ.).

12. Arutyunov G.P., Arhipov M.V., Bakalov S.A., Bokarev I.N., Vyshlov E.V., Gilyarevskiy S.R. et al. Mesto i znachenie nablyudatel'nyh issledovanij NOAK u pacientov s neklapannoj fibrillyaciej predserdij s pozicii mediciny, osnovannoj na dokazatel'stvah [Place and significance of observational studies of NOACs in patients with non-valvular atrial fibrillation from the standpoint of evidence-based medicine]. Serdce: zhurnal dlja praktikujushhih vrachej [Russian Heart Journal] 2016; 15(6): 441-447. doi: 10.18087/rhj.2016.6.2297. (In Russ.).

13. Bel'diev S.N., Medvedeva I.V., Platonov D.Y., Trufanova G.Y. Issledovaniya antikoagulyantnoj terapii u «hrupkih» pozhilyh pacientov: problemy terminologii i metodologii [Studies of anticoagulant therapy in frail elderly patients: problems of terminology and methodology]. Racional'naja Farmakoterapija v Kardiologii [Rational Pharmacotherapy in Cardiology] 2019; 15(2): 251-257. doi: 10.20996/1819-6446-2019-15-2-251-257. (In Russ.).

14. Beasley B.N., Unger E.F., Temple R. Anticoagulant options – why the FDA approved a higher but not a lower dose of dabigatran. N Engl J Med 2011; 364(19): 1788-1790. doi: 10.1056/NEJMp1103050.

15. Fomin V.V., Svistunov A.A., Napalkov D.A., Sokolova A.A., Gabitova M.A. Pryamye peroral'nye antikoagulyanty u pacientov s fibrillyaciej predserdij v vozraste 75 let i starshe: balans effektivnosti i bezopasnosti [Direct oral anticoagulants in atrial fibrillation patients aged 75 years or older: Efficacy and safety balance]. Terapevticheskij arhiv [Therapeutic Archive] 2017; 89(4): 4-7. doi: 10.17116/terarkh20178944-7. (In Russ.).

16. Hariharan S., Madabushi R. Clinical pharmacology basis of deriving dosing recommendations for dabigatran in patients with severe renal impairment. J Clin Pharmacol 2012; 52(S1): 119S-125S. doi: 10.1177/0091270011415527.

17. Gosudarstvennyj reestr lekarstvennyh sredstv. Instrukciya po primeneniyu lekarstvennogo preparata dlya medicinskogo primeneniya Pradaksa [The State Register of Medicinal Products of the Russian Federation. Pradaxa (dabigatran etexilate): summary of product characteristics]. URL: https://grls.rosminzdrav.ru. (cited: October 30, 2019) (In Russ.).