ノート
有害事象自発報告データベースを用いた直接経口抗凝固薬による中枢神経系出血性有害事象に対するプロトンポンプ阻害薬併用の影響に関する解析
キーワード:
adverse event reporting system,
direct oral anticoagulants,
proton pump inhibitor,
survival analysis
2023 年 49 巻 6 号 p. 231-240
詳細
2023 年 49 巻 6 号 p. 231-240
Proton pump inhibitors (PPIs) have been widely co-administrated to patients with atrial fibrillation who are receiving anticoagulant therapy with a direct oral anticoagulant drug (DOAC), to prevent gastrointestinal bleeding. However, there has been controversy over whether there is an effect of co-administered PPIs on the onset of central nervous system bleeding, which also leads a poor prognosis. We therefore examined the effects of PPIs on the onset timing of adverse drug reactions to DOACs, using the Japanese adverse event reporting database, JADER. After adjusting risk factors for bleeding, the results obtained show that the onset timing of central nervous system bleeding is earlier in rivaroxaban-administered patients co-administered with a PPI as compared to non-PPI-co-administered patients. These results suggest that co-treatment with PPI and rivaroxaban may be a risk factor accelerating the onset of central nervous system bleeding.
