Клинико-фармакологическое и клиническое обоснование кратности применения новых пероральных антикоагулянтов

В данном обзоре литературы обсуждается вопрос приверженности пациентов к лечению антикоагулянтами как одного из факторов, позволяющих обеспечить эффективную и безопасную терапию. Низкая приверженность к лечению может приводить к тяжелым последствиям: ухудшению течения заболевания, увеличению затрат здравоохранения, повышению смертности. Существуют следующие барьеры для соблюдения рекомендаций по дозе и режиму терапии: забывчивость, другие приоритеты, решение пропустить дозу, недостаток информации, недостаток понимания; эмоциональные причины, сложность режима дозирования. Имеются данные о том, что прием антикоагулянтов один раз в сутки может сопровождаться более высокой приверженностью к лечению в сравнении с двукратным режимом дозирования. В обзоре представлено сравнение фармакокинетики новых пероральных антикоагулянтов (дабигатрана, ривароксабана, апиксабана и эдоксабана), отражены принципы выбора режимов дозирования этих препаратов для III фазы клинических испытаний с участием пациентов с фибрилляцией предсердий и венозными тромбоэмболиями. По результатам нескольких исследований показано, что пациенты, получающие ингибитор Ха фактора с однократным приемом (ривароксабан), имеют большую вероятность быть приверженными к лечению, чем пациенты, принимающие апиксабан или дабигатран.

антикоагулянты, ривароксабан, дабигатран, апиксабан, эдоксабан, фармакокинетика, фармакодинамика, клинические исследования, anticoagulants, rivaroxaban, dabigatran, apixaban, edoxaban, pharmacokinetics, pharmacodynamics, clinical trials

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