Thrombo 360 Dialogues: Recent Episodes
Frank
Get the latest news and views on thrombosis management, with interviews and commentary from the world's leading experts in cardiovascular disease, haematology, and thrombosis management.
In this episode Dr Harry Gibbs, from The Alfred Hospital in Victoria and Dr Ander Cohen from Guy’s and St Thomas’ Hospital, King’s College in London, UK talk about the management of patients on therapy who have an ischaemic stroke. They talk about potential causes of stroke – whether the stroke may be medication related or unrelated to medication, and when it is safe to restart anticoagulation.
ELIQUIS® (apixaban)
PBS Information: Authority required (STREAMLINED) Refer to PBS Schedule for full authority information.
PBS Codes: NVAF – 4269 and DVT/Pe initial treatment – 4298 (DVT); 5098 (PE). Other PBS codes differ – please refer to PBS Schedule.
NVAF: Non-valvular atrial fibrillation; DVT: Deep vein thrombosis; PE: Pulmonary embolism.
Before prescribing, please review full ELIQUIS Product Information available from Bristol Myers Squibb Australia by calling 1800 067 567
Please note that in the Aristotle study, patients were excluded if they had experienced an ischaamic stroke within the previous 7 days. There are limited data on the timing of restarting anticoagulation post stroke.
ELIQUIS Consumer Medical InformationELIQUIS Product Information
References
-
Granger CB, Alexander JH, McMurray JJ et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365: 981-92.
-
Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007; 146: 857-67.
t360 is an educational program supported by Bristol Myers Squibb Australia Pty Ltd, ABN 33 004 333 322, Level 2, 4 Nexus Court, Mulgrave VIC 3170 and Pfizer Australia Pty Ltd, ABN 50 008 422 348, 151 Clarence Street, Level 15–18, Sydney NSW 2000, and developed by Elixir Healthcare Education Pty Limited, ABN 36 092 185 665, Level 32, 101 Miller Street, North Sydney NSW 2060. ©Copyright 2022 Bristol Myers Squibb–Pfizer Alliance and Elixir Healthcare Education Pty Limited. PP-ELI-AUS-1096.
In this episode Dr Harry Gibbs, from The Alfred Hospital in Victoria and Dr Ander Cohen from Guy’s and St Thomas’ Hospital, King’s College in London, UK discuss the exciting potential for artificial intelligence to inform the treatment decisions of clinicians managing patients with cardiovascular disease. From the interpretation of optical investigations, to using machine learning algorithms to assess data and diagnose asymptomatic disease, AI techniques have the promise to improve the treatment and quality of life of patients with cardiovascular disease.
ELIQUIS® (apixaban)
PBS Information: Authority required (STREAMLINED) Refer to PBS Schedule for full authority information.
PBS Codes: NVAF – 4269 and DVT/Pe initial treatment – 4298 (DVT); 5098 (PE). Other PBS codes differ – please refer to PBS Schedule.
NVAF: Non-valvular atrial fibrillation; DVT: Deep vein thrombosis; PE: Pulmonary embolism.
Before prescribing, please review full ELIQUIS Product Information available from Bristol Myers Squibb Australia by calling 1800 067 567
ELIQUIS Consumer Medical Information
ELIQUIS Product Informationt360 is an educational program supported by Bristol Myers Squibb Australia Pty Ltd, ABN 33 004 333 322, Level 2, 4 Nexus Court, Mulgrave VIC 3170 and Pfizer Australia Pty Ltd, ABN 50 008 422 348, 151 Clarence Street, Level 15–18, Sydney NSW 2000, and developed by Elixir Healthcare Education Pty Limited, ABN 36 092 185 665, Level 32, 101 Miller Street, North Sydney NSW 2060. ©Copyright 2022 Bristol Myers Squibb–Pfizer Alliance and Elixir Healthcare Education Pty Limited. PP-ELI-AUS-1098.
In this episode Dr Harry Gibbs, from The Alfred Hospital in Victoria and Dr Ander Cohen from Guy’s and St Thomas’ Hospital, King’s College in London, UK talk about managing recurrence in venous thromboembolism patients, and the importance of optimising therapy to minimise recurrence risk. They talk about the potential for drug interactions in patients on multiple medications such as those with cancer, and the challenges of maintaining anticoagulation in patients who may be experiencing the side-effects of other medications.
ELIQUIS® (apixaban)
PBS Information: Authority required (STREAMLINED) Refer to PBS Schedule for full authority information.
PBS Codes: NVAF – 4269 and DVT/Pe initial treatment – 4298 (DVT); 5098 (PE). Other PBS codes differ – please refer to PBS Schedule.
NVAF: Non-valvular atrial fibrillation; DVT: Deep vein thrombosis; PE: Pulmonary embolism.
Before prescribing, please review full ELIQUIS Product Information available from Bristol Myers Squibb Australia by calling 1800 067 567
Please note that apixaban is contraindicated in patients with malignant neoplasms at high risk of bleeding. The efficacy and safety of apixaban for the treatment of DVT/PE in patients with active cancer is not established.
ELIQUIS Consumer Medical Information
ELIQUIS Product Information
References
- Cohen A, Keshishian A, Lee T et al. Effectiveness and Safety of Apixaban, Low-Molecular-Weight Heparin, and Warfarin among Venous Thromboembolism Patients with Active Cancer: A U.S. Claims Data Analysis. Thromb Haemost 2021; 121: 383-95.
t360 is an educational program supported by Bristol Myers Squibb Australia Pty Ltd, ABN 33 004 333 322, Level 2, 4 Nexus Court, Mulgrave VIC 3170 and Pfizer Australia Pty Ltd, ABN 50 008 422 348, 151 Clarence Street, Level 15–18, Sydney NSW 2000, and developed by Elixir Healthcare Education Pty Limited, ABN 36 092 185 665, Level 32, 101 Miller Street, North Sydney NSW 2060. ©Copyright 2022 Bristol Myers Squibb–Pfizer Alliance and Elixir Healthcare Education Pty Limited. PP-ELI-AUS-1097.
In this episode Dr Harry Gibbs, from The Alfred Hospital in Victoria and Dr Ander Cohen from Guy’s and St Thomas’ Hospital, King’s College in London, UK discuss how to interpret real world data and how to identify well designed and useful observational studies. They consider the strengths and weaknesses of real-world data, and their importance in instances where head to head studies do not exist, or in patient populations not covered by the original clinical studies.
ELIQUIS® (apixaban)
PBS Information: Authority required (STREAMLINED) Refer to PBS Schedule for full authority information.
PBS Codes: NVAF – 4269 and DVT/Pe initial treatment – 4298 (DVT); 5098 (PE). Other PBS codes differ – please refer to PBS Schedule.
NVAF: Non-valvular atrial fibrillation; DVT: Deep vein thrombosis; PE: Pulmonary embolism.
Before prescribing, please review full ELIQUIS Product Information available from Bristol Myers Squibb Australia by calling 1800 067 567
ELIQUIS Consumer Product InformationELIQUIS Product Information
References
-
Agnelli G, Buller HR, Cohen A et al. Oral apixaban for the treatment of acute venous thromboembolism. N Engl J Med 2013; 369: 799-808.
-
Agnelli G, Buller HR, Cohen A et al. Apixaban for extended treatment of venous thromboembolism. N Engl J Med 2013; 368: 699-708.
-
Menichelli D, Del Sole F, Di Rocco A et al. Real-world safety and efficacy of direct oral anticoagulants in atrial fibrillation: a systematic review and meta-analysis of 605 771 patients. Eur Heart J Cardiovasc Pharmacother 2021; 7: f11-f19.
t360 is an educational program supported by Bristol Myers Squibb Australia Pty Ltd, ABN 33 004 333 322, Level 2, 4 Nexus Court, Mulgrave VIC 3170 and Pfizer Australia Pty Ltd, ABN 50 008 422 348, 151 Clarence Street, Level 15–18, Sydney NSW 2000, and developed by Elixir Healthcare Education Pty Limited, ABN 36 092 185 665, Level 32, 101 Miller Street, North Sydney NSW 2060. ©Copyright 2022 Bristol Myers Squibb–Pfizer Alliance and Elixir Healthcare Education Pty Limited. PP-ELI-AUS-1095.
In this episode Dr Harry Gibbs, from The Alfred Hospital in Victoria and Dr Ander Cohen from Guy’s and St Thomas’ Hospital, King’s College in London, UK consider the management of patients with extreme body weight. Can we safely use DOACs in patients with increased weight, and what does the trial evidence and guidelines show? Harry and Ander discuss these issues, as well as the management of patients at the other extreme, those with very low bodyweight.
ELIQUIS® (apixaban)
PBS Information: Authority required (STREAMLINED) Refer to PBS Schedule for full authority information.
PBS Codes: NVAF – 4269 and DVT/Pe initial treatment – 4298 (DVT); 5098 (PE). Other PBS codes differ – please refer to PBS Schedule.
NVAF: Non-valvular atrial fibrillation; DVT: Deep vein thrombosis; PE: Pulmonary embolism.
Before prescribing, please review full ELIQUIS Product Information available from Bristol Myers Squibb Australia by calling 1800 067 567
Please note that no dose adjustment of ELIQUIS is needed in patients of extreme body weight, except for atrial fibrillation patients with at least two of the following criteria, body weight ≤60 kg, age ≥80 years, or serum creatinine ≥133 µmol/L.
ELIQUIS Consumer Medical InformationELIQUIS Product Information
References
-
Agnelli G, Buller HR, Cohen A et al. Oral apixaban for the treatment of acute venous thromboembolism. N Engl J Med 2013; 369: 799-808.
-
Agnelli G, Buller HR, Cohen A et al. Apixaban for extended treatment of venous thromboembolism. N Engl J Med 2013; 368: 699-708.
-
Cohen AT, Pan S, Byon W et al. Efficacy, Safety, and Exposure of Apixaban in Patients with High Body Weight or Obesity and Venous Thromboembolism: Insights from AMPLIFY. Adv Ther 2021; 38: 3003-18.
t360 is an educational program supported by Bristol Myers Squibb Australia Pty Ltd, ABN 33 004 333 322, Level 2, 4 Nexus Court, Mulgrave VIC 3170 and Pfizer Australia Pty Ltd, ABN 50 008 422 348, 151 Clarence Street, Level 15–18, Sydney NSW 2000, and developed by Elixir Healthcare Education Pty Limited, ABN 36 092 185 665, Level 32, 101 Miller Street, North Sydney NSW 2060. ©Copyright 2022 Bristol Myers Squibb–Pfizer Alliance and Elixir Healthcare Education Pty Limited. PP-ELI-AUS-1094.
In this episode Dr Harry Gibbs, from The Alfred Hospital in Victoria and Dr Ander Cohen from Guy’s and St Thomas’ Hospital, King’s College in London, UK discuss the impacts of COVID on their clinical practice. This included logistical aspects such as staff shortages, less hospital visits and the challenges of managing acute presentations, but also positives such as the transition to telehealth which has worked well in some settings.
ELIQUIS® (apixaban)
PBS Information: Authority required (STREAMLINED) Refer to PBS Schedule for full authority information.
PBS Codes: NVAF – 4269 and DVT/Pe initial treatment – 4298 (DVT); 5098 (PE). Other PBS codes differ – please refer to PBS Schedule.
NVAF: Non-valvular atrial fibrillation; DVT: Deep vein thrombosis; PE: Pulmonary embolism.
Before prescribing, please review full ELIQUIS Product Information available from Bristol Myers Squibb Australia by calling 1800 067 567
Consumer Medical InformationProduct Information
t360 is an educational program supported by Bristol Myers Squibb Australia Pty Ltd, ABN 33 004 333 322, Level 2, 4 Nexus Court, Mulgrave VIC 3170 and Pfizer Australia Pty Ltd, ABN 50 008 422 348, 151 Clarence Street, Level 15–18, Sydney NSW 2000, and developed by Elixir Healthcare Education Pty Limited, ABN 36 092 185 665, Level 32, 101 Miller Street, North Sydney NSW 2060. ©Copyright 2022 Bristol Myers Squibb–Pfizer Alliance and Elixir Healthcare Education Pty Limited. PP-ELI-AUS-1092.
In this episode Dr Harry Gibbs, from The Alfred Hospital in Victoria and Dr Ander Cohen from Guy’s and St Thomas’ Hospital, King’s College in London, UK discuss stroke prevention with DOACs in patients with chronic kidney disease. They talk about how often renal function should be monitored, and how to manage falling creatinine clearance levels in the face of an increased risk of stroke, and increased bleeding risk, as a result of the kidney disease .
ELIQUIS® (apixaban)
PBS Information: Authority required (STREAMLINED) Refer to PBS Schedule for full authority information.
PBS Codes: NVAF – 4269 and DVT/Pe initial treatment – 4298 (DVT); 5098 (PE). Other PBS codes differ – please refer to PBS Schedule.
NVAF: Non-valvular atrial fibrillation; DVT: Deep vein thrombosis; PE: Pulmonary embolism.
Before prescribing, please review full ELIQUIS Product Information available from Bristol Myers Squibb Australia by calling 1800 067 567
Please note that apixaban is contraindicated in patients with creatine clearance levels less than 25 mL/min.
ELIQUIS Consumer Medical InformationELIQUIS Product Information
Reference
- Cohen AT, Sah J, Dhamane AD et al. Effectiveness and Safety of Apixaban versus Warfarin in Venous Thromboembolism Patients with Chronic Kidney Disease. Thromb Haemost 2021. doi: 10.1055/s-0041-1740254. Epub ahead of print.
t360 is an educational program supported by Bristol Myers Squibb Australia Pty Ltd, ABN 33 004 333 322, Level 2, 4 Nexus Court, Mulgrave VIC 3170 and Pfizer Australia Pty Ltd, ABN 50 008 422 348, 151 Clarence Street, Level 15–18, Sydney NSW 2000, and developed by Elixir Healthcare Education Pty Limited, ABN 36 092 185 665, Level 32, 101 Miller Street, North Sydney NSW 2060. ©Copyright 2022 Bristol Myers Squibb–Pfizer Alliance and Elixir Healthcare Education Pty Limited. PP-ELI-AUS-1093.
In this episode Dr Harry Gibbs, from The Alfred Hospital in Victoria and Dr Ander Cohen from Guy’s and St Thomas’ Hospital, King’s College in London, UK discuss the management of ongoing treatment with DOACs in patients with cancer. They consider the additional provoking factors in cancer patients, when it might be safe to reduce the dose, and the additional treatment challenges of maintaining efficacy in patients at increased risk of bleeding.
ELIQUIS® (apixaban)
PBS Information: Authority required (STREAMLINED) Refer to PBS Schedule for full authority information.
PBS Codes: NVAF – 4269 and DVT/Pe initial treatment – 4298 (DVT); 5098 (PE). Other PBS codes differ – please refer to PBS Schedule.
NVAF: Non-valvular atrial fibrillation; DVT: Deep vein thrombosis; PE: Pulmonary embolism.
Before prescribing, please review full ELIQUIS Product Information available from Bristol Myers Squibb Australia by calling 1800 067 567.
Please note that apixaban is contraindicated in patients with malignant neoplasms at high risk of bleeding. The efficacy and safety of apixaban for the treatment of DVT/PE in patients with active cancer is not established.
ELIQUIS Consumer Medical InformationELIQUIS Product Information
Reference
- Lyman GH, Carrier M, Ay C et al. American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer. Blood Adv 2021; 5: 927-74.
t360 is an educational program supported by Bristol Myers Squibb Australia Pty Ltd, ABN 33 004 333 322, Level 2, 4 Nexus Court, Mulgrave VIC 3170 and Pfizer Australia Pty Ltd, ABN 50 008 422 348, 151 Clarence Street, Level 15–18, Sydney NSW 2000, and developed by Elixir Healthcare Education Pty Limited, ABN 36 092 185 665, Level 32, 101 Miller Street, North Sydney NSW 2060. ©Copyright 2022 Bristol Myers Squibb–Pfizer Alliance and Elixir Healthcare Education Pty Limited. PP-ELI-AUS-1091.