Prof Guy Richards (University of the Witwatersrand) comments on the importance of the Einstein-PE study for South African clinicians

摘要

This is an interesting study, the first assessing utilisation of one of the new orally available anticoagulants to treat pulmonary embolism. The outcomes were similar with regard to prevention of recurrence but there were differences with regard to safety. Whereas overall major or clinically relevant non-major bleeding was the same, overall major bleeding episodes did differ, with 26 (1.1%) occurring in the rivaroxaban group and 52 (2.2%) in the standard-therapy group. This difference had a standard deviation of 0.49 (95% confidence interval of 0.31-0.79) and was significant (p = 0.003). Within this latter group was included other non-fatal episodes in critical sites, and a large proportion of the differences within the group of major bleeds was made up of intra-cerebral bleeds, which occurred in one patient (< 0.1%) with rivaroxaban, and 10 (0.4%) with standard therapy.