Использование пероральных антикоагулянтов прямого действия у пациентов с множественной миеломой, принимающих иммуномодуляторы

УДК 615.036.2

Аннотация

Резюме. Иммуномодулирующие препараты (ИМП) используются для лечения многих гематологических злокачественных новообразований, при этом их применение связано с повышенным риском венозных тромбоэмболических ослож- нений (ВТЭО), что требует проведения тромбопрофилактики. Всё чаще в практической медицине используются прямые пероральные антикоагулянты (ПОАК). В настоящее время продолжается изучение роли этих препаратов при наличии у пациентов злокачественных новообразований. Целью настоящего обзора явилась оценка безопасности и эффектив- ности применения ПОАК в качестве тромбопрофилактики у пациентов с множественной миеломой (ММ), получающих ИМП. Были проанализированы клинические исследования, а также отчёты о клинических случаях, опубликованных в мировой литературе с 2014 по 2021 гг. В работе систематизирована информация о тромботических явлениях и кровотечениях, заре- гистрированных в данных исследованиях. Результаты анализа говорят об эффективности и безопасности применения ПОАК у пациентов с ММ, находящихся на терапии ИМП. Таким образом, ПОАК могут представлять собой привлекательную альтернативу варфарину, ацетилсалициловой кислоте и низкомолекулярным гепаринам для профилактики ВТЭО у этой группы пациентов. В работе также обсуждаются проблемы, связанные с применением ПОАК, и возможные пути их решения.

Литература

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