1. [Direct Oral Anticoagulants in elderly with multimorbidity: what precautions?]
- Author
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Alameda B, Hannou S, Derême J, Tsilimidos G, Alberio L, D'amelio P, and Bosshard Taroni W
- Subjects
- Humans, Aged, Administration, Oral, Hemorrhage chemically induced, Hemorrhage epidemiology, Hemorrhage prevention & control, Factor Xa Inhibitors administration & dosage, Factor Xa Inhibitors adverse effects, Polypharmacy, Multimorbidity, Anticoagulants administration & dosage, Anticoagulants adverse effects
- Abstract
Elderly with multimorbidity are at higher risk of accumulating direct oral anticoagulants (DOAC). The presence of renal insufficiency, an extreme age or weight, a limited functional reserve, and a polypharmacy that may interact with DOAC, lead to an increased risk of bleeding. A medication review and an evaluation of DOAC exposure in this population could help identify this risk and better manage it. This evaluation is conducted in collaboration with coagulation experts through calibrated measurement of anti-Xa (rivarobaxan, apixaban and edoxaban), along with D-dimers measurement as a potential tool to assess thrombo-hemorrhagic risk. In the event of DOAC accumulation, experts could then propose personalized intervention, such as a dose reduction or a switch to another DOAC., Competing Interests: les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article. more...
- Published
- 2024
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