Perspective - Der Pharmacia Lettre ( 2024) Volume 16, Issue 2
Received: 30-Jan-2024, Manuscript No. DPL-24-129641;
Editor assigned: 01-Feb-2024, Pre QC No. DPL-24-129641 (PQ);
Reviewed: 15-Feb-2024, QC No. DPL-24-129641;
Revised: 22-Feb-2024, Manuscript No. DPL-24-129641 (R);
Published:
01-Mar-2024
, DOI: 10.37532/dpl.2024.16.17
, Citations: Natalia Z 2024. Strategies for Minimizing Bleeding Risks with Antithrombotic Drugs. Der
Pharma Lett.16:17-18
,
Copyright: © 2024 Natalia Z. This is an open-access article distributed under the terms of the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
While thrombolytics are primarily utilized for intravenous thrombolysis in cases of ischemic stroke, anticoagulants are essential in the prevention of venous thromboembolism. Antiplatelet medications are highly successful in treating and preventing ischemic stroke and myocardial infarction caused by arterial thrombosis. Up to 5% of people suffer from the common and possibly fatal disease known as thrombosis. Antithrombotic medications, which can completely prevent or significantly reduce the risk of thrombotic or embolic events, are the cornerstone of thrombosis prevention and treatment. Various medical disorders require the use of antithrombotic medicines, such as thrombolytics, anticoagulants, and antiplatelet drugs, for thrombolysis.
All antithrombotic medications carry some risk of bleeding, regardless of the specific medical condition. While the relative risk is 30% lower with direct oral anticoagulation, the rate of symptomatic cerebral bleeding in stroke patients treated with alteplase is roughly 6%-8%, and significant bleeding episodes may occur in 1%-3% of patients receiving vitamin K antagonists annually. Thrombolysis can cause a wide range of bleeding symptoms, from mild bleeding to potentially fatal bleeding. A patient's view of their quality of life may be negatively impacted by even minor bleeding, which could lead to a reduction in their adherence to thrombolytic therapy. Thus, during thrombolysis, it's critical to keep the ratio of ischemia to bleeding limited. Even though pre-marketing research has sufficiently examined the safety of antithrombotic drugs, post-market monitoring is still essential since it gathers long-term data and offers fresh perspectives on how these medications are used in clinical settings. As the main instruments for pharmacovigilance, Spontaneous Reporting Systems (SRS) are an invaluable resource for obtaining current information about the safety and efficacy profile of medications and vaccines, evaluating available treatments, and learning about potential causes of Adverse Drug Reactions (ADRs).
While the risk of bleeding from various antithrombotic drugs has been compared in some studies, there hasn't been much research done on the time-to-onset of thrombolysis-induced bleeding.
By preventing platelet activation or blood coagulation, antithrombotic medications prevent thrombosis and prevent a number of cardiovascular disorders. However, this mechanism frequently increases the risk of bleeding in patients. Using a large and thorough spontaneous reporting system database, comparison of the risk of bleeding caused by several antithrombotic medications in a broad cohort of patients undergoing antithrombotic therapy is made in this study. To further elucidate the manner in which the risk of bleeding varies during administration, we also conducted a TTO analysis of haemorrhage associated with antithrombotic medication. In conclusion, our research offered pertinent information to help with patient pharmacological treatment in clinical settings. Time-to-onset analysis were carried out to look at the onset profiles of hemorrhagic ADRs caused by antithrombotic medicines. According to our findings, the majority of antithrombotic drugs' hemorrhagic Adverse Drug Reactions (ADRs) had random failure profiles, indicating a continuous risk over time. Specifically, the risk of hemorrhagic Adverse Drug Reactions (ADRs) rose with alteplase, nadroparin, and dipyridamole over time, but it decreased with warfarin and clopidogrel. The cumulative incidence curve of bleeding events in clinical trials and real-world research can be used to assess the failure type, even if there aren't many published results of TTO analysis for antithrombotic medicines. The event may be of the early type when the slope of the curve reduces with time, the wear-out type when it grows greater with time, and the random type when it is practically constant.
Researchers evaluated ticagrelor with clopidogrel for the prevention of cardiovascular events in 18,624 individuals with acute coronary syndrome in a multicenter, double-blind, randomized trial. Their examination of the cumulative incidence of significant bleeding suggested that the risk of bleeding decreased with time for clopidogrel, which is consistent with our findings. Another recent trial examined the advantages of clopidogrel monotherapy in individuals with acute coronary syndrome and chronic coronary syndrome following a single 1-month DAPT as opposed to a 12-month DAPT. Our findings are further supported by the safety analysis results, which indicated that the risk of bleeding with clopidogrel alone after one 1-month DAPT was decreased in the later phases of treatment. More research is necessary because the bleeding failure type caused by clopidogrel monotherapy is yet poorly understood.
Citation: Natalia Z 2024. Strategies for Minimizing Bleeding Risks with Antithrombotic Drugs. Der Pharma Lett.16:17-18
Copyright: © 2024 Natalia Z. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
