rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2016-12-2-220-226rpcardio-1240Research ArticleCURRENT QUESTIONS OF CLINICAL PHARMACOLOGYАКТУАЛЬНЫЕ ВОПРОСЫ КЛИНИЧЕСКОЙ ФАРМАКОЛОГИИTHE EFFICACY AND SAFETY OF NEW ORAL ANTICOAGULANTS IN PATIENTS WITH ATRIAL FIBRILLATION IN CLINICAL PRACTICEЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ НОВЫХ ПЕРОРАЛЬНЫХ АНТИКОАГУЛЯНТОВ У БОЛЬНЫХ С ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙ В КЛИНИЧЕСКОЙ ПРАКТИКЕМоисеевС. В.MoiseevS. V.

Моисеев Сергей Валентинович – доктор медицинских наук, профессор кафедры внутренних, профессиональных болезней и пульмонологии Первого МГМУ имени И.М. Сеченова, профессор кафедры внутренних болезней факультета фундаментальной медицины МГУ имени М.В. Ломоносова

avt420034@gmail.comПервый Московский государственный медицинский университет имени И.М. Сеченова, Москва; Московский государственный университет имени М.В. ЛомоносоваРоссияI.M. Sechenov First Moscow State Medical University, Moscow; M.V. Lomonosov Moscow State University , MoscowRussian Federation201605052016122220226Copyright © Moiseev S.V., 20162016Моисеев С.В.Moiseev S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/1240

New oral anticoagulants that inhibit factor Xa (rivaroxaban, apixaban, edoksaban) or thrombin (dabigatran), today are increasingly replacing warfarin and other indirect anticoagulants in preventing stroke in patients with non-valvular atrial fibrillation. They were superior to warfarin for some indicators of efficacy and safety in randomized controlled trials. However, the experience of their study in real clinical practice is limited. The need in prospective, observational studies is dictated by the fact that usual practice differs from the conditions of the randomized clinical trials that may improve the efficiency and safety of the treatment, including the expense of strict criteria for patient selection, regular visits, constant safety monitoring and etc. The results of prospective observational XANTUS study and retrospective cohort studies that shown similar results of treatment with new oral anticoagulants in randomized clinical trials and routine clinical practice are presented in the review.

Новые пероральные антикоагулянты, ингибирующие фактор Xa (ривароксабан, апиксабан, эдоксабан) или тромбин (дабигатран), сегодня все чаще заменяют варфарин и другие непрямые антикоагулянты в профилактике инсульта у больных с неклапанной фибрилляцией предсердий. В рандомизированных контролируемых исследованиях они превосходили варфарин по некоторым показателям эффективности или безопасности, однако опыт их изучения в обычной клинической практике ограничен. Необходимость в проспективных наблюдательных исследованиях в «реальной жизни» диктуется тем, что условия проведения рандомизированных клинических исследований отличаются от обычной практики, что может способствовать повышению эффективности и безопасности лечения, в том числе за счет жестких критериев отбора пациентов, регулярных визитов, постоянного мониторирования безопасности и т.п. В обзорной статье приведены результаты проспективного наблюдательного исследования XANTUS, а также ретроспективных когортных исследований, в которых были показаны сходные результаты лечения новыми пероральными антикоагулянтами в рандомизированных клинических исследованиях и в обычной клинической практике.

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The authors declare that there are no conflicts of interest present.