Edoxaban-a non-vitamin K antagonist oral anticoagulant (NOAC)- 60-mg and 30-mg once-daily dose regimens are noninferior versus well-managed warfarin for the prevention of stroke or systemic embolic events (SEE) with less major bleeding in patients with nonvalvular atrial fibrillation (NVAF). There are no published data from phase 3 clinical trials specifically evaluating the use of NOACs in elderly NVAF patients, especially those considered ineligible for available oral anticoagulants. The Edoxaban Low-Dose for EldeR CARE AF patients (ELDERCARE-AF) study is a phase 3, randomized, double-blind, placebo-controlled, parallel-group, multicenter study that will compare the safety and efficacy of once-daily edoxaban 15 mg versus placebo in Japanese patients with NVAF ≥80 years of age who are considered ineligible for standard oral anticoagulant therapy. A total of 800 patients (400 in each treatment group) are planned for randomization (1:1) to either edoxaban or placebo using a stratified randomization method with CHADS2 index score (2 points, ≥3 points) as a factor. The primary efficacy end point is the time to first onset of stroke or SEE. The net clinical outcome is the composite of stroke, SEE, major bleeding, and all-cause mortality. The primary safety end point is the incidence of major bleeding. The treatment period will continue until 65 patients with the primary efficacy events (ie, stroke or SEE) have been observed (2- to 2.5-year expected mean treatment period). The results of ELDERCARE-AF may provide clarity as to the efficacy and safety of edoxaban for the prevention of stroke or SEE in this high-risk population.

译文

:Edoxaban-一种非维生素K拮抗剂口服抗凝剂(NOAC)-60毫克和30毫克每日一次的剂量方案与良好管理的华法林相比,在预防中风或全身性栓塞事件(SEE)且大出血少的情况下效果不差非瓣膜性房颤(NVAF)的患者。没有3期临床试验的公开数据专门评估老年NVAF患者,尤其是那些认为不适合口服抗凝剂的NOAC的使用。 Edoxaban EldeR CARE AF患者低剂量(ELDERCARE-AF)研究是一项3期,随机,双盲,安慰剂对照,平行组,多中心研究,将比较每日一次edoxaban的安全性和有效性15在日本NVAF≥80岁的患者中,mg与安慰剂比较,被认为不符合标准口服抗凝治疗的条件。计划使用分层随机化方法,以CHADS2指数评分(2分,≥3分)为因子,将总共800名患者(每个治疗组400名)随机分配(1:1)到依多沙班或安慰剂中。主要功效终点是中风或SEE首次发作的时间。最终的临床结果是中风,SEE,大出血和全因死亡率的综合结果。主要安全终点是大出血的发生率。治疗期将持续到观察到65位具有主要疗效事件(即中风或SEE)的患者(预期平均治疗期为2至2.5年)。 ELDERCARE-AF的结果可能为埃德沙班预防高危人群中风或SEE的有效性和安全性提供了明确的依据。

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