Review
Pharmacology & Pharmacy
Costas Thomopoulos, John Ntalakouras, Dimitris Polyzos, Dimitris Konstantinidis, Lina Palaiodimou, Georgios Tsivgoulis, Costas Tsioufis
Summary: This study conducted a meta-analysis of randomized trials to compare the efficacy and safety of low-dose DOACs and warfarin in preventing ischemic stroke and systemic embolism in patients with non-valvular Atrial Fibrillation. The results showed that low-dose DOACs had a more favorable net clinical benefit profile compared to warfarin.
PHARMACOLOGICAL RESEARCH
(2022)
Review
Cardiac & Cardiovascular Systems
Maxim Grymonprez, Cynthia Simoens, Stephane Steurbaut, Tine L. De Backer, Lies Lahousse
Summary: The introduction of NOACs has significantly increased the use of oral anticoagulants among atrial fibrillation patients worldwide. However, there is still room for improvement as a portion of patients are not receiving anticoagulation therapy or are only being treated with antiplatelet monotherapy.
Article
Cardiac & Cardiovascular Systems
Songnan Wen, Cristina Pislaru, Kristi H. Monahan, Stephanie M. Barnes, David O. Hodge, Douglas L. Packer, Sorin Pislaru, Samuel J. Asirvatham
Summary: This study found that overall atrial fibrillation recurrence after ablation was similar with NOACs or warfarin use, but in patients with persistent AF, NOACs use was associated with a higher probability of arrhythmia recurrence and was an independent risk factor for recurrence in long-term follow-up.
CARDIOVASCULAR DRUGS AND THERAPY
(2022)
Article
Cardiac & Cardiovascular Systems
Daehoon Kim, Pil-Sung Yang, Eunsun Jang, Hee Tae Yu, Tae-Hoon Kim, Jae-Sun Uhm, Jong-Youn Kim, Jung-Hoon Sung, Hui-Nam Pak, Moon-Hyoung Lee, Gregory Y. H. Lip, Boyoung Joung
Summary: The study found that among patients with atrial fibrillation, non-vitamin K antagonist oral anticoagulants (NOACs) were associated with a lower risk of dementia.
Article
Medicine, General & Internal
Fabrice F. F. Darche, Lisa C. C. Fabricius, Matthias Helmschrott, Ann-Kathrin Rahm, Philipp Ehlermann, Tom Bruckner, Wiebke Sommer, Gregor Warnecke, Norbert Frey, Rasmus Rivinius
Summary: Little is known about the post-transplant use of direct oral anticoagulants (DOACs) in patients after heart transplantation (HTX). We investigated the frequency, indications, and complications of DOACs and vitamin K antagonists (VKAs) in HTX recipients. The results showed that DOACs were associated with significantly fewer bleeding complications compared to VKAs, but there were no differences in the risk of ischemic stroke, thromboembolic events, or OAC-related death between the two groups.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Cardiac & Cardiovascular Systems
Angelo Silverio, Marco Di Maio, Costantina Prota, Elena De Angelis, Ilaria Radano, Rodolfo Citro, Albino Carrizzo, Michele Ciccarelli, Carmine Vecchione, Davide Capodanno, Gennaro Galasso
Summary: In elderly patients with atrial fibrillation, NOACs are associated with a lower risk of stroke, intracranial bleeding, hemorrhagic stroke, and fatal bleeding compared to VKAs, but increase the risk of gastrointestinal bleedings. The safety profiles of individual NOAC agents vary significantly.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2021)
Article
Cardiac & Cardiovascular Systems
Chun-Li Wang, Victor Chien-Chia Wu, Yu-Tung Huang, Yu-Ling Chen, Pao-Hsien Chu, Chang-Fu Kuo, Ming-Shien Wen, Shang-Hung Chang
Summary: After experiencing hematuria, it is unclear to what extent patients resume VKA or NOAC. A cohort study in Taiwan revealed that patients resuming NOAC had similar risks of ischemic stroke/systemic embolism and major bleeding compared to those resuming VKA. Over time, the proportion of patients resuming NOAC has increased, while VKA resumption and non-resumption have decreased.
JOURNAL OF THROMBOSIS AND THROMBOLYSIS
(2021)
Article
Hematology
Alexandra E. Mihm, Arefa Bacchus, Kathleen J. Harb, Richard A. Menear, Sarah A. Nisly
Summary: This retrospective study evaluated the efficacy and safety of DOACs compared to warfarin in patients with IVC thrombus. The results showed no significant differences in thrombus resolution and bleeding risk between DOACs and warfarin within 6 months. However, the study is limited by a small patient population and availability of repeat imaging.
EUROPEAN JOURNAL OF HAEMATOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Yujiro Yokoyama, Alexandros Briasoulis, Hiroki Ueyama, Makoto Mori, Masao Iwagami, Naoki Misumida, Hisato Takagi, Toshiki Kuno
Summary: DOACs may decrease the risk of major bleeding without increasing the risk of stroke or all-cause death compared with VKA in patients with bioprosthetic valves and atrial fibrillation.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Norman Mangner, Miriam Brinkert, Lukas S. Keller, Noriaki Moriyama, Daniel Hagemeyer, Stephan Haussig, Lisa Crusius, Richard Kobza, Mohamed Abdel-Wahab, Mika Laine, Stefan Stortecky, Thomas Pilgrim, Fabian Nietlispach, Frank Ruschitzka, Holger Thiele, Stefan Toggweiler, Axel Linke
Summary: This study aimed to investigate the safety and effectiveness of continued non-vitamin K antagonist oral anticoagulant (NOAC) therapy compared with continued vitamin K antagonist (VKA) therapy during transcatheter aortic valve implantation (TAVI). The study found that continued NOAC therapy led to comparable outcomes to continued VKA therapy, suggesting that both drugs can be used for long-term oral anticoagulation in TAVI patients.
Article
Cardiac & Cardiovascular Systems
Jin-Yi Hsu, Peter Pin-Sung Liu, An-Bang Liu, Shu-Man Lin, Huei-Kai Huang, Ching-Hui Loh
Summary: This study found that patients with AF using NOACs had a lower risk of dementia compared to those using warfarin, especially in the age group of 65 to 74 years with a high risk of stroke or bleeding.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Review
Cardiac & Cardiovascular Systems
Xiaojuan Wu, Linyan Hu, Jinjin Liu, Qiuping Gu
Summary: This meta-analysis indicated that DOACs were associated with a reduced risk of any fracture compared to VKAs, especially apixaban and rivaroxaban. Further studies are needed to confirm these findings.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Review
Cardiac & Cardiovascular Systems
Wenhao Li, Yanxia Zhou, Siqi Chen, Dewang Zeng, Haidong Zhang
Summary: In patients with atrial fibrillation undergoing dialysis, the use of NOACs, particularly factor Xa inhibitors (rivaroxaban or apixaban), showed similar effectiveness and safety outcomes compared to warfarin.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Medicine, General & Internal
Enrico Guido Spinoni, Chiara Ghiglieno, Simona Costantino, Eleonora Battistini, Gabriele Dell'Era, Stefano Porcellini, Matteo Santagostino, Federica De Vecchi, Giulia Renda, Giuseppe Patti
Summary: This study compares the occurrence of post-procedural bleeding complications between patients with atrial fibrillation undergoing cardiac implantable electronic device (CIED) intervention who were treated with non-vitamin K antagonist anticoagulants (NOACs) or vitamin K antagonist anticoagulants (VKAs). The results suggest that NOACs may be associated with a lower incidence of post-intervention pocket hematoma compared to VKAs.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Pajaree Mongkhon, Laura Fanning, Kirstie H. T. W. Wong, Kenneth K. C. Man, Ian C. K. Wong, Wallis C. Y. Lau
Summary: This study suggests that non-vitamin K antagonist oral anticoagulants (NOACs) are associated with a lower risk of fractures compared to vitamin K antagonists (VKAs) for patients with atrial fibrillation (AF). Among NOACs, the fracture risks were similar.
Article
Gastroenterology & Hepatology
Olivier Govaere, Sine Kragh Petersen, Nuria Martinez-Lopez, Jasper Wouters, Matthias Van Haele, Rosellina M. Mancina, Oveis Jamialahmadi, Orsolya Bilkei-Gorzo, Pierre Bel Lassen, Rebecca Darlay, Julien Peltier, Jeremy M. Palmer, Ramy Younes, Dina Tiniakos, Guruprasad P. Aithal, Michael Allison, Michele Vacca, Melker Goransson, Rolando Berlinguer-Palmini, James E. Clark, Michael J. Drinnan, Hannele Yki-Jarvinen, Jean-Francois Dufour, Mattias Ekstedt, Sven Francque, Salvatore Petta, Elisabetta Bugianesi, Jorn M. Schattenberg, Christopher P. Day, Heather J. Cordell, Baki Topal, Karine Clement, Stefano Romeo, Vlad Ratziu, Tania Roskams, Ann K. Daly, Quentin M. Anstee, Matthias Trost, Anetta Hartlova
Summary: MSR1 plays a critical role in the pathogenesis of obesity-associated NAFLD by regulating lipid uptake and accumulation, influencing hepatic inflammation and metabolic disorder, and could be a potential therapeutic target for the treatment of NAFLD.
JOURNAL OF HEPATOLOGY
(2022)
Article
Gastroenterology & Hepatology
John B. Whitfield, Tae-Hwi Schwantes-An, Rebecca Darlay, Guruprasad P. Aithal, Stephen R. Atkinson, Ramon Bataller, Greg Botwin, Naga P. Chalasani, Heather J. Cordell, Ann K. Daly, Christopher P. Day, Florian Eyer, Tatiana Foroud, Dermot Gleeson, David Goldman, Paul S. Haber, Jean-Marc Jacquet, Tiebing Liang, Suthat Liangpunsakul, Steven Masson, Philippe Mathurin, Romain Moirand, Andrew McQuillin, Christophe Moreno, Marsha Y. Morgan, Sebastian Mueller, Beat Muellhaupt, Laura E. Nagy, Pierre Nahon, Bertrand Nalpas, Sylvie Naveau, Pascal Perney, Munir Pirmohamed, Helmut K. Seitz, Michael Soyka, Felix Stickel, Andrew Thompson, Mark R. Thursz, Eric Trepo, Timothy R. Morgan, Devanshi Seth
Summary: This study developed a genetic risk score that can identify individuals at high risk of developing cirrhosis. It was found that the risk of cirrhosis is increased over 10-fold in patients with diabetes and a high genetic risk score. This risk assessment could lead to early and personalized management of the disease in high-risk patients.
JOURNAL OF HEPATOLOGY
(2022)
Article
Genetics & Heredity
Marijana Vujkovic, Shweta Ramdas, Kim M. Lorenz, Xiuqing Guo, Rebecca Darlay, Heather J. Cordell, Jing He, Yevgeniy Gindin, Chuhan Chung, Robert P. Myers, Carolin V. Schneider, Joseph Park, Kyung Min Lee, Marina Serper, Rotonya M. Carr, David E. Kaplan, Mary E. Haas, Matthew T. MacLean, Walter R. Witschey, Xiang Zhu, Catherine Tcheandjieu, Rachel L. Kember, Henry R. Kranzler, Anurag Verma, Ayush Giri, Derek M. Klarin, Yan V. Sun, Jie Huang, Jennifer E. Huffman, Kate Townsend Creasy, Nicholas J. Hand, Ching-Ti Liu, Michelle T. Long, Jie Yao, Matthew Budoff, Jingyi Tan, Xiaohui Li, Henry J. Lin, Yii-Der Ida Chen, Kent D. Taylor, Ruey-Kang Chang, Ronald M. Krauss, Silvia Vilarinho, Joseph Brancale, Jonas B. Nielsen, Adam E. Locke, Marcus B. Jones, Niek Verweij, Aris Baras, K. Rajender Reddy, Brent A. Neuschwander-Tetri, Jeffrey B. Schwimmer, Arun J. Sanyal, Naga Chalasani, Kathleen A. Ryan, Braxton D. Mitchell, Dipender Gill, Andrew D. Wells, Elisabetta Manduchi, Yedidya Saiman, Nadim Mahmud, Donald R. Miller, Peter D. Reaven, Lawrence S. Phillips, Sumitra Muralidhar, Scott L. DuVall, Jennifer S. Lee, Themistocles L. Assimes, Saiju Pyarajan, Kelly Cho, Todd L. Edwards, Scott M. Damrauer, Peter W. Wilson, J. Michael Gaziano, Christopher J. O'Donnell, Amit V. Khera, Struan F. A. Grant, Christopher D. Brown, Philip S. Tsao, Danish Saleheen, Luca A. Lotta, Lisa Bastarache, Quentin M. Anstee, Ann K. Daly, James B. Meigs, Jerome I. Rotter, Julie A. Lynch, Daniel J. Rader, Benjamin F. Voight, Kyong-Mi Chang
Summary: Through a multi-ancestry genome-wide association study, we identified multiple genetic loci associated with NAFLD in the Million Veteran Program, some of which are also related to metabolic and/or inflammatory traits. Integrating cALT, histology, and imaging provided new insights into genetic susceptibility to NAFLD.
Article
Pharmacology & Pharmacy
Roseann S. Gammal, Munir Pirmohamed, Andrew A. Somogyi, Sarah A. Morris, Christine M. Formea, Amanda L. Elchynski, Kazeem A. Oshikoya, Howard L. McLeod, Cyrine E. Haidar, Michelle Whirl-Carrillo, Teri E. Klein, Kelly E. Caudle, Mary Relling
Summary: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is associated with the development of acute hemolytic anemia in the presence of oxidative stress. This guideline provides information on using G6PD genotype for diagnosing G6PD deficiency and categorizes medications based on their risk level in individuals with G6PD deficiency. High-risk medications should be avoided, medium-risk medications should be used with caution, and low-risk medications can be used without considering the G6PD phenotype.
CLINICAL PHARMACOLOGY & THERAPEUTICS
(2023)
Review
Pharmacology & Pharmacy
Innocent G. Asiimwe, Munir Pirmohamed
Summary: Cardiovascular disease remains a leading cause of both morbidity and mortality worldwide. Both concomitant medications and genomic factors can influence the efficacy and safety outcomes of cardiovascular drugs. However, there is a lack of research on drug-drug-gene interactions (DDGIs) and other complex interactions. Multimorbidity and polypharmacy in cardiovascular disease patients increase the risk of clinically relevant drug-related interactions, leading to reduced drug efficacy and increased adverse reactions.
PHARMACOGENOMICS & PERSONALIZED MEDICINE
(2022)
Article
Pharmacology & Pharmacy
Muhammed Shiraz Moosa, Giusy Russomanno, Jeffrey R. Dorfman, Hannah Gunter, Chandni Patel, Eithne Costello, Dan Carr, Gary Maartens, Munir Pirmohamed, Christopher Goldring, Karen Cohen
Summary: This study investigated the concentrations of miR-122 in participants with antituberculosis drug-induced liver injury (AT-DILI) and its correlation with alanine aminotransferase (ALT) concentrations. The study found that miR-122 concentrations in AT-DILI patients were significantly higher than those in healthy volunteers and in patients on antituberculosis therapy without liver injury, and N-acetylcysteine (NAC) had no effect on miR-122 concentrations.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2023)
Article
Pharmacology & Pharmacy
Tjeerd Pieter van Staa, Munir Pirmohamed, Anita Sharma, Iain Buchan, Darren M. Ashcroft
Summary: This study evaluated drug-drug interactions (DDIs) between antibiotics and nonantibiotic drugs listed with warnings of severe outcomes in the British National Formulary. The results showed no substantial risk of DDIs despite the warnings in the national formulary.
CLINICAL PHARMACOLOGY & THERAPEUTICS
(2023)
Review
Genetics & Heredity
Munir Pirmohamed
Summary: In this Review, the current state of the pharmacogenomics field is discussed, along with clinically relevant drug-gene associations and the steps required for implementing pharmacogenomics into clinical practice. The role of pharmacogenomics in drug discovery and development is also considered. The variability in drug response between individuals, which can be attributed to genomic factors, is a global concern. Despite the availability and decreasing cost of genotyping technologies, challenges in implementing pharmacogenomics lie in adapting current clinical pathways and addressing the knowledge gap in healthcare professionals. Furthermore, pharmacogenomics shows promise in enhancing drug discovery and development outcomes.
NATURE REVIEWS GENETICS
(2023)
Article
Public, Environmental & Occupational Health
Elpida Kontsioti, Simon Maskell, Munir Pirmohamed
Summary: This study aimed to evaluate the impact of multiple design criteria for reference sets used to assess the performance of signal detection algorithms for drug-drug interactions. Custom-made reference sets of different sizes were generated based on various design criteria. The performance metrics of three algorithms were assessed using FDA Adverse Event Reporting System data, and the results showed that the composition of reference sets significantly impacted the evaluation metrics.
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY
(2023)
Review
Geriatrics & Gerontology
Eve Braithwaite, Oliver M. Todd, Abigail Atkin, Rachel Hulatt, Ragy Tadrous, David P. Alldred, Munir Pirmohamed, Lauren Walker, Rebecca Lawton, Andrew Clegg
Summary: A systematic review with meta-analysis was conducted to examine interventions aimed at reducing anticholinergic burden in older adults. The results showed no significant difference in outcomes between control and intervention group for falls, cognition, anticholinergic burden, or quality of life. Short follow-up time and lack of training and support surrounding successful deprescribing may have contributed to these results.
Article
Pharmacology & Pharmacy
Victoria Rollinson, Neil French, Richard Turner, Munir Pirmohamed
Summary: This study aimed to assess the current educational status of pharmacogenomics within the UK pharmacy profession and identify future educational and infrastructure needs of pharmacists. A survey was conducted among practicing pharmacists, preregistration pharmacists, and MPharm students. The findings indicate the need for further education and the development of PGx guidelines to prepare the pharmacy workforce for PGx implementation.
JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS
(2023)
Article
Public, Environmental & Occupational Health
Tjeerd Pieter van Staa, Munir Pirmohamed, Anita Sharma, Darren M. M. Ashcroft, Iain Buchan
Summary: This study aims to assess the relationship between medication classes and adverse drug reactions (ADR) and emergency hospital admission. Through big data analysis, it was found that certain medication classes have a higher risk of ADR-related hospitalization. Therefore, there is a need for regular systematic assessment of the harm-benefit ratio of medicines.
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY
(2023)
Article
Public, Environmental & Occupational Health
Sofia Attelind, Niclas Eriksson, Anders Sundstroem, Mia Wadelius, Par Hallberg
Summary: Data mining in a pharmacovigilance database identified known and potential novel risk factors for bleeding associated with direct oral anticoagulants.
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY
(2023)
Article
Multidisciplinary Sciences
Sylvia Hartmann, Summaira Yasmeen, Benjamin M. Jacobs, Spiros Denaxas, Munir Pirmohamed, Eric R. Gamazon, Mark J. Caulfield, Harry Hemingway, Maik Pietzner, Claudia Langenberg
Summary: The study identified three novel genomic regions related to Raynaud's phenomenon risk, prioritized candidate causal genes, and revealed a likely detrimental effect of low fasting glucose levels on RP risk. The research also highlighted opportunities for drug repurposing and provided robust evidence for a strong genetic contribution to RP.
NATURE COMMUNICATIONS
(2023)
Article
Gastroenterology & Hepatology
Brian Ho, Andrew Thompson, Andrea L. Jorgensen, Munir Pirmohamed
Summary: This study assessed the utility of the fatty liver index (FLI) for risk stratification of non-alcoholic fatty liver disease (NAFLD) and associated comorbidities. The results showed that FLI can effectively identify the risk of NAFLD and related comorbidities, including cardiovascular metabolic diseases and malignant tumors, and is closely associated with all-cause mortality risk.
