Should a physician use the Beers criteria when prescribing direct oral anticoagulants to elderly patients?
The Beers Criteria are a tool for optimizing pharmacotherapy in elderly patients, containing information on potentially inappropriate drugs, which is only advisory in nature and is not mandatory for use in Russian Federation. In the updated version of the Beers Criteria from 2023, the expert opinion...
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Столичная издательская компания
2024-10-01
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| Series: | Рациональная фармакотерапия в кардиологии |
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| Online Access: | https://www.rpcardio.online/jour/article/view/3089 |
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| author | N. M. Vorobyeva I. P. Malaya V. D. Zakiev O. N. Tkacheva |
| author_facet | N. M. Vorobyeva I. P. Malaya V. D. Zakiev O. N. Tkacheva |
| author_sort | N. M. Vorobyeva |
| collection | DOAJ |
| description | The Beers Criteria are a tool for optimizing pharmacotherapy in elderly patients, containing information on potentially inappropriate drugs, which is only advisory in nature and is not mandatory for use in Russian Federation. In the updated version of the Beers Criteria from 2023, the expert opinion on rivaroxaban has changed — instead of "use with caution", as stated in the previous document from 2019, the experts now believe that "long-term treatment with rivaroxaban in non-valvular atrial fibrillation (AF) and venous thromboembolic complications (VTE) should be avoided in favor of safer alternative anticoagulants". This statement is based on moderate-quality evidence obtained from observational studies and network meta-analyses, which are significantly inferior to randomized controlled trials and have numerous limitations. The available evidence base for the use of rivaroxaban in elderly patients with AF and VTE and critical comments on the Beers criteria methodology, indicate the recommendations of the American Geriatrics Society experts regarding direct oral anticoagulants (DOAC) should be treated thoughtfully and carefully. When choosing a DOAC in elderly patients with AF or VTE, one should primarily focus on current clinical guidelines mandatory for use in Russian Federation, and on the data of studies that studied the efficacy and safety of specific DOACs in this category of patients. Rivaroxaban is a well-studied anticoagulant in elderly patients with AF and VTE, since its efficacy and safety have been established in RCTs and specially designed multicenter prospective observational studies with a fairly high quality of evidence. Based on this, rivaroxaban is a justified treatment option for elderly and senile patients with AF or VTE. |
| format | Article |
| id | doaj-art-802cbd04defc492d93b88c6ca7a71540 |
| institution | Kabale University |
| issn | 1819-6446 2225-3653 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Столичная издательская компания |
| record_format | Article |
| series | Рациональная фармакотерапия в кардиологии |
| spelling | doaj-art-802cbd04defc492d93b88c6ca7a715402025-08-23T10:00:37ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532024-10-0120446046710.20996/1819-6446-2024-30892224Should a physician use the Beers criteria when prescribing direct oral anticoagulants to elderly patients?N. M. Vorobyeva0I. P. Malaya1V. D. Zakiev2O. N. Tkacheva3Russian Gerontological Scientific and Clinical Center, Pirogov Russian National Research Medical UniversityRussian Gerontological Scientific and Clinical Center, Pirogov Russian National Research Medical UniversityRussian Gerontological Scientific and Clinical Center, Pirogov Russian National Research Medical UniversityRussian Gerontological Scientific and Clinical Center, Pirogov Russian National Research Medical UniversityThe Beers Criteria are a tool for optimizing pharmacotherapy in elderly patients, containing information on potentially inappropriate drugs, which is only advisory in nature and is not mandatory for use in Russian Federation. In the updated version of the Beers Criteria from 2023, the expert opinion on rivaroxaban has changed — instead of "use with caution", as stated in the previous document from 2019, the experts now believe that "long-term treatment with rivaroxaban in non-valvular atrial fibrillation (AF) and venous thromboembolic complications (VTE) should be avoided in favor of safer alternative anticoagulants". This statement is based on moderate-quality evidence obtained from observational studies and network meta-analyses, which are significantly inferior to randomized controlled trials and have numerous limitations. The available evidence base for the use of rivaroxaban in elderly patients with AF and VTE and critical comments on the Beers criteria methodology, indicate the recommendations of the American Geriatrics Society experts regarding direct oral anticoagulants (DOAC) should be treated thoughtfully and carefully. When choosing a DOAC in elderly patients with AF or VTE, one should primarily focus on current clinical guidelines mandatory for use in Russian Federation, and on the data of studies that studied the efficacy and safety of specific DOACs in this category of patients. Rivaroxaban is a well-studied anticoagulant in elderly patients with AF and VTE, since its efficacy and safety have been established in RCTs and specially designed multicenter prospective observational studies with a fairly high quality of evidence. Based on this, rivaroxaban is a justified treatment option for elderly and senile patients with AF or VTE.https://www.rpcardio.online/jour/article/view/3089beers criteriadirect oral anticoagulantsrivaroxabanapixabandabigatranwarfarinelderlyefficacysafety |
| spellingShingle | N. M. Vorobyeva I. P. Malaya V. D. Zakiev O. N. Tkacheva Should a physician use the Beers criteria when prescribing direct oral anticoagulants to elderly patients? Рациональная фармакотерапия в кардиологии beers criteria direct oral anticoagulants rivaroxaban apixaban dabigatran warfarin elderly efficacy safety |
| title | Should a physician use the Beers criteria when prescribing direct oral anticoagulants to elderly patients? |
| title_full | Should a physician use the Beers criteria when prescribing direct oral anticoagulants to elderly patients? |
| title_fullStr | Should a physician use the Beers criteria when prescribing direct oral anticoagulants to elderly patients? |
| title_full_unstemmed | Should a physician use the Beers criteria when prescribing direct oral anticoagulants to elderly patients? |
| title_short | Should a physician use the Beers criteria when prescribing direct oral anticoagulants to elderly patients? |
| title_sort | should a physician use the beers criteria when prescribing direct oral anticoagulants to elderly patients |
| topic | beers criteria direct oral anticoagulants rivaroxaban apixaban dabigatran warfarin elderly efficacy safety |
| url | https://www.rpcardio.online/jour/article/view/3089 |
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