Klinische Studien zu neuen direkten oralen Antikoagulanzien

Zusammenfassung

Um die Wirksamkeit und Verträglichkeit neuer direkter oraler Antikoagulanzien (DOAK) zu vergleichen, müssten idealerweise eine direkte Gegenüberstellung der Substanzen in klinischen Studien durchgeführt werden. Auf Grund des logistischen und finanziellen Aufwandes wird dies aber in absehbarer Zeit nicht geschehen. Indirekte Vergleiche, auch Netzwerkanalysen (NMA) genannt, lassen sich mit den vorliegenden Studien zwischen den DOAKs vornehmen. In der postoperativen Phase nach Knie- und Hüftgelenkersatz und bei Patienten mit Vorhofflimmern sind derzeit diese Vergleich möglich. Indirekte Vergleiche sind jedoch auch mit Einschränkungen behaftet.

Diese Arbeit gibt eine Übersicht der aktuell vorliegenden NMAs und versucht, deren Ergebnisse mit der Pharmakologie der DOAKs und den methodischen Problemen von NMAs zu beleuchten.

Schlüsselwörter

Antikoagulanzien - Apixaban - Dabigatran - Rivaroxaban - Edoxaban - Vorhofflimmern - postoperative Thromboembolieprophylaxe

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