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Fibrillazione atriale negli anziani, con LIXIANA® (edoxaban) bassa incidenza di emorragie e di eventi cardiovascolari. I dati real world ad un anno di follow up del Registro ETNA-AF EUROPE presentati a Pechino

Dal registro globale ETNA-AF, i risultati real-world sui pazienti anziani europei affetti da fibrillazione atriale (FA) non valvolare trattati con edoxaban, ad un anno hanno dimostrato una bassa incidenza di emorragie potenzialmente fatali e di eventi cardiovascolari. Il programma globale ETNA-AF attualmente è il più ampio e completo registro di dati sull’utilizzo, l’efficacia e la sicurezza di un singolo anticoagulante orale diretto in pazienti con FA trattati nel “mondo reale”. I dati raccolti in 825 Centri clinici europei confermano l’efficacia e la sicurezza di edoxaban nella pratica clinica quotidiana.

Roma 12 ottobre 2019 – Daiichi Sankyo ha presentato oggi, al Great Wall International Congress of Cardiology (GW-ICC) di Pechino, i risultati real world ad un anno di follow-up del registro ETNA-AF (Edoxaban Treatment in routiNe clinical prActice). I dati sono stati raccolti su 12.574 pazienti europei, per la maggior parte anziani, affetti da fibrillazione atriale non valvolare (FANV) e trattati con LIXIANA® (edoxaban),

Nel primo anno di terapia con edoxaban, nei pazienti arruolati in 825 Centri clinici europei, è stata registrata una bassa incidenza di sanguinamenti (maggiori e gastrointestinali), di emorragia intracranica e di eventi ischemici. In particolare:1

  • Gli episodi di sanguinamento maggiore (definizione ISTH) si sono verificati solo nell'1,05% (n=125) dei pazienti, quelli di emorragia intracranica nello 0,23% (n=28), e i sanguinamenti gastro-intestinali maggiori nello 0,39% (n=47) dei soggetti.
  • Ictus ischemici si sono verificati nello 0,54% (n=65), attacchi ischemici transitori nello 0,37% (n=44), e ictus emorragici nello 0,11% (n=13) dei pazienti.

L’incidenza di eventi embolici sistemici (EES) e di infarto miocardico è stata generalmente bassa. In un anno si sono verificati rispettivamente in 13 (0.11%) e 63 (0.53%) pazienti1.

 Anche la mortalità è stata bassa. In totale, in un anno, la mortalità per tutte le cause è stata osservata nel 3,55% (n=425) dei pazienti, e la mortalità cardiovascolare nell’1.67% (n=200) dei casi.1             

Sebbene l’incidenza di ictus, emorragie, mortalità cardiovascolare e mortalità per tutte le cause aumenti con l’età, non è stato osservato un incremento nell’incidenza delle emorragie intracraniche correlato all’età, e la frequenza è stata bassa in tutti i gruppi.

“Nella pratica clinica quotidiana, l’incidenza dei sanguinamenti maggiori e dei sanguinamenti non maggiori clinicamente rilevanti nei pazienti anziani trattati con edoxaban è stata più bassa di quella osservata nel setting degli studi clinici registrativi. Inoltre, in questi pazienti è risultata bassa anche la frequenza di tutti gli altri eventi cardiovascolari. -  Ha spiegato Raffaele De Caterina, professore di Cardiologia, Istituto di Cardiologia dell'Università di Pisa – La fibrillazione atriale è la più comune forma di aritmia in pazienti ultra 65enni, e la sua prevalenza aumenta con l’età. Per questa ragione diventa cruciale per noi analizzare il profilo di efficacia e sicurezza di edoxaban nella popolazione anziana”.

Il programma globale ETNA –AF, che attualmente è il più ampio e completo registro di dati sull’utilizzo, l’efficacia e la sicurezza di un singolo anticoagulante orale diretto in pazienti con FA trattati nella pratica clinica di routine, ha raccolto dati da un totale di 24.962 soggetti arruolati in 2.242 Centri distribuiti in Giappone, Corea/Taiwan ed Europa.

 “Questi risultati positivi forniscono importanti indicazioni sul profilo di efficacia e sicurezza di edoxaban nei pazienti con fibrillazione atriale non valvolare, in particolare in quelli anziani e/o con comorbilità, che sono considerati ad alto rischio di eventi cardiovascolari. -  ha commentato Wolfgang Zierhut, MD, direttore esecutivo del Medical Affairs e capo della sezione Thrombosis and Cardiovascular di Daiichi Sankyo Europa – I dati di ETNA-AF dimostrano che i risultati di efficacia e sicurezza del trial di fase III ENGAGE AF-TIMI-48 sono confermati nella pratica clinica in tutta Europa”.

 

ETNA-AF 

ETNA-AF (Edoxaban Treatment in routiNe clinical prActice in patients with nonvalvular Atrial Fibrillation) è un programma globale che combina dati da distinti studi non interventistici condotti in Europa, Asia orientale e Giappone in un unico database. Un totale di più di 28.000 pazienti saranno inclusi nei Registri ETNA –AF e seguiti per 2 anni (in Europa per 4 anni). L’obiettivo primario di ETNA –AF è raccogliere informazioni sull’uso di edoxaban nella pratica clinica quotidiana, inclusi i profili di efficacia e sicurezza in pazienti con FANV non selezionati. [i],[ii],[iii],[iv],[v]

 

Riferimenti

[1] De Caterina, R. et al. One-year Outcomes of Major Bleeding, Stroke and Mortality in Approximately 25,000 AF Patients Treated with Edoxaban in Routine Clinical Practice: Snapshot from Global Noninterventional ETNA-AF Program. Abstract presented at GW-ICC Congress 2019.

[2] Edoxaban Treatment in Routine Clinical Practice for Patients With Non Valvular Atrial Fibrillation (ETNA-AF-EU). Available at: clinicaltrials.gov/ct2/show/NCT02944019. [Last accessed: October 2019].

[3] Edoxaban Treatment in Routine Clinical Practice for Patients With Atrial Fibrillation in Korea and Taiwan (ETNA-AF-KOR-TWN). Available at: clinicaltrials.gov/ct2/show/NCT02951039. [Last accessed: October 2019].

[4] Edoxaban Treatment in Routine Clinical Practice for Patients With Non-valvular Atrial Fibrillation (ETNA-AF-Hong Kong). Available at: clinicaltrials.gov/ct2/show/NCT03247582. [Last accessed: October 2019].

[5] Edoxaban Treatment in Routine Clinical Practice for Patients With Non-Valvular Atrial Fibrillation (NVAF). Available at: clinicaltrials.gov/ct2/show/NCT03247569. [Last accessed: October 2019].

[6] ETNA-AF-Japan. Available at: upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi [Last accessed: October 2019].

[7] National Heart, Lung and Blood Institute – What is Atrial Fibrillation. Available at: www.nhlbi.nih.gov/health/dci/Diseases/af/af_diagnosis.html. [Last accessed: October 2019].