抗うつ薬併用下における直接経口抗凝固薬による出血リスクの検討
「緒言」直接経口抗凝固薬(direct oral anticoagulants: DOAC)はトロンビンや第Xa因子を選択的に阻害し, トロンビン産生総量の抑制や産生速度を遅延させることで抗凝固活性を示す. DOACは, ビタミンK拮抗薬であるワルファリンと比較して, prothrombin time-international normalized ratio(PT-INR)による厳密なモニタリングを必要としない, 食事による影響がない, 服用後に速やかに効果を発現する, 薬効の個人差が少ない, 頭蓋内出血が少ないなどの利点が知られている. そのため, 各種ガイドラインにおいて, DOACは...
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| Published in | 医療薬学 Vol. 48; no. 9; pp. 419 - 428 |
|---|---|
| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人日本医療薬学会
10.09.2022
日本医療薬学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1346-342X 1882-1499 |
| DOI | 10.5649/jjphcs.48.419 |
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| Abstract | 「緒言」直接経口抗凝固薬(direct oral anticoagulants: DOAC)はトロンビンや第Xa因子を選択的に阻害し, トロンビン産生総量の抑制や産生速度を遅延させることで抗凝固活性を示す. DOACは, ビタミンK拮抗薬であるワルファリンと比較して, prothrombin time-international normalized ratio(PT-INR)による厳密なモニタリングを必要としない, 食事による影響がない, 服用後に速やかに効果を発現する, 薬効の個人差が少ない, 頭蓋内出血が少ないなどの利点が知られている. そのため, 各種ガイドラインにおいて, DOACは心房細動, 深部静脈血栓症, 肺血栓塞栓症などの予防や治療に対する標準治療薬として位置づけられている. DOACのうち, リバーロキサバン, アピキサバンおよびエドキサバンはシトクロムP450 3A4(CYP3A4)を介して代謝される. また, 全てのDOACがP糖タンパク質の基質である. |
|---|---|
| AbstractList | 「緒言」直接経口抗凝固薬(direct oral anticoagulants: DOAC)はトロンビンや第Xa因子を選択的に阻害し, トロンビン産生総量の抑制や産生速度を遅延させることで抗凝固活性を示す. DOACは, ビタミンK拮抗薬であるワルファリンと比較して, prothrombin time-international normalized ratio(PT-INR)による厳密なモニタリングを必要としない, 食事による影響がない, 服用後に速やかに効果を発現する, 薬効の個人差が少ない, 頭蓋内出血が少ないなどの利点が知られている. そのため, 各種ガイドラインにおいて, DOACは心房細動, 深部静脈血栓症, 肺血栓塞栓症などの予防や治療に対する標準治療薬として位置づけられている. DOACのうち, リバーロキサバン, アピキサバンおよびエドキサバンはシトクロムP450 3A4(CYP3A4)を介して代謝される. また, 全てのDOACがP糖タンパク質の基質である. |
| Author | 小島, 悠輔 圓東, 寛基 片田, 佳希 重面, 雄紀 米澤, 淳 中川, 俊作 村井, 俊哉 松原, 和夫 杉田, 尚子 山本, 将太 中川, 貴之 寺田, 智祐 |
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| References | 11）日本ペインクリニック学会編, “神経障害性疼痛薬物療法ガイドライン”, 改訂第2版, 真興交易, 東京, 2016, pp48-51 4）Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounaemaux H, Huisman M, King CS, Morris TA, Sood N, Stevens SM, Vintch JRE, Wells P, Woller SC, Moores L, Antithrombotic therapy for VTE disease: CHEST guideline and export panel report, Chest, 2016, 149, 315-352. 24）Jiang HY, Chen HZ, Hu XJ, Yu ZH, Yang W, Deng M, Zhang YH, Ruan B, Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding: a systematic review and meta-analysis, Clin Gastroenterol Hepatol, 2015, 13, 42-50. 6）Konstantinides SV, Torbicki A, Angelli G, Danchin N, Fitzmaurice D, Galie N, Gibbs JS, Humbert M, Kucher N, Lang I, Lankeit M, Lekakis J, Maack C, Mayer E, Meneveau N, Perrier A, Pruszczyk P, Rasmussen LH, Schindeler TH, Scitil P, Vonk Noordegraaf A, Zamorano JL, Zompatori M, Take force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC), Eur Heart J, 2014, 35, 3033-3069. 30）Hackett ML, Yapa C, Parag V, Anderson CS, Frequency of depression after stroke: a systematic review of observational studies, Stroke, 2005, 36, 1330-1340. 1）van Gorp RH, Schurgers LJ, New insights into the pros and cons of the clinical use of vitamin K antagonists (VKAs) versus direct oral anticoagulants (DOACs), Nutrients, 2015, 7, 9538-9557. 8）Galgani A, Palleria C, Iannnone LF, De Sarro G, Giorgi FS, Maschio M, Russo E, Pharmacokinetic interaction of clinical interest between direct oral anticoagulants and antiepileptic drugs, Front Neurol, 2018, 9, 1067-1076. 17）Wallerstedt SM, Gleerup H, Sundström A, Stigendal L, Ny L, Risk of clinically relevant bleeding in warfarin-treated patients--influence of SSRI treatment, Pharmacoepidemiol Drug Saf, 2009, 18, 412-416. 10）National Institute for Health and Care Excellence. Depression in adults: recognition and management. Clinical guideline 90, 2009, last updated April 2016. 13）Palmsten K, Diaz SH, Huybrechts K, Williams P, Michels K, Achtyes E, Mogun H, Setoguchi S, Use of antidepressants near delivery and risk of postpartum hemorrhage: cohort study of low income women in the United States, BMJ, 2013, 347, f4877. 21）Lincoff AM, Bittl JA, Harrington RA, Feit F, Kleiman NS, Jackman JD, Sarembock IJ, Cohen DJ, Spriggs D, Ebrahimi R, Keren G, Carr J, Cohen EA, Betriu A, Desmet W, Kereiakes DJ, Rutsch W, Wilcox RG, Feyter PJ, Vahanian A, Topol EJ, Blockade compared with heparin and planned glycoprotein Ⅱb/Ⅲa blockade during percutaneous coronary intervention, JAMA, 2003, 289, 853-863. 22）Eikelboom JW, Wallentin L, Connolly SJ, Ezekowitz M, Healey JS, Oldgren J, Yang S, Alings M, Kaatz S, Hohnloser SH, Diener HC, Franzosi MG, Huber K, Reilly P, Varrone J, Yusuf S, Risk of bleeding with 2 dose of dabigatran compared with warfarin in older and younger patients with atrial fibrillation. An analysis of the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial, Circulation, 2011, 123, 2363-2372. 3）日本循環器学会, 循環器病ガイドラインシリーズ2020年版：不整脈薬物治療ガイドライン（2020年改訂版）. https://www.j-circ.or.jp/cms/wp-content/uploads/2020/01/JCS2020_Ono.pdf, 2021年12月. 31）Caeiro L, Ferro JM, Costa J, Apathy secondary to stroke: a systematic review and meta-analysis, Cerebrovasc Dis, 2013, 35, 23-39. 5）Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, Boriani G, Castellà M, Dan G, Dilaveris P, Fauchier L, Filippatos G, Kalman J, Meir ML, Lane D, Lebeau J, Lettino M, Lip G, Pinto F, Thomas G, Valgimigli M, van Gelder IV, van Putte BV, Watkins C, 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC, Eur Heart J, 2021, 42, 373-498. 2）Cabral KP, Pharmacology of the new target-specific oral anticoagulants, J Thromb Thrombolysis, 2013, 36, 133-140. 9）Foerster KI, Hermann S, Mikus G, Haefeli WE, Drug-drug interactions with direct oral anticoagulants, Clinical Pharmacokinetics, 2020, 59, 967-980. 18）Schalekamp T, Klungel OH, Souverein PC, Boer AD, Increased bleeding risk with concurrent use of selective serotonin reuptake inhibitors and coumarins, Arch Intern Med, 2008, 168, 180-185. 26）Loke YK, Trivedi AN, Singh S, Meta-analysis: gastrointestinal bleeding due to interaction between selective serotonin uptake inhibitors and non-steroidal anti-inflammatory drugs, Aliment Pharmacol Ther, 2008, 27, 31-40. 23）Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJGM, Lip GYH, A nove; user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the euro heart survey, CHEST, 2010, 138, 1093-1100. 14）Dalton S, Johasen C, Mellemkjaer L, Norgard B, Sorensen H, Olsen J, Use of selective serotonin reuptake inhibitors and risk upper gastrointestinal tract bleeding: a population-based cohort study, Arch Intern Med, 2003, 163, 59-64. 16）Laporte S, Chapelle C, Caillet P, Beyens M, Bellet F, Delavenne X, Mismetti P, Betoletti L, Bleeding risk under selective serotonin reuptake inhibitor (SSRI)antidepressants: a meta-analysis of observational studies, Pharmacol Res, 2017, 118, 19-32. 28）Shimada K, Hasegawa S, Nakao S, Mukai R, Sasaoka S, Ueda N, Kato Y, Abe J, Mori T, Yoshimura T, Kinosada Y, Nakamura M, Adverse reaction profiles of hemorrhagic adverse reactions caused by direct oral anticoagulants nalyzed using the Food and Drug Administration Adverse Event Reporting System (FAERS) database and the Japanese Adverse Drug Event Report (JADER) database, Int J Medical Sci, 2019, 16, 1295-1303. 29）Dworkin RH, O’Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS, Kalso EA, Loeser JD, Miaskowski C, Nurmikko TJ, Portenoy RK, Rice ASC, Stacey BR, Treede RD, Turk DC, Wallace MS, Pharmacologic management of neuropathic pain: Evidence-based recommendations, Pain, 2007, 132, 237-251. 7）Voukalis C, Lip GY, Shantsila E, Drug-drug interactions of non-vitamin K oral anticoagulants, Export Opin Drug Metab Toxicol, 2016, 12, 1445-1461. 19）Lee MT, Park KY, Kim MS, You SH, Kang YJ, Jung SY, Concomitant use of NSAIDs or SSRIs with NOACs requires monitoring for bleeding, YMJ, 2020, 61, 741-749. 12）Paton C, Ferrier I, SSRIs and gastrointestinal bleeding, BMJ, 2005, 331, 529-530. 15）Smoller J, Allison M, Cochrane B, Club J, Perlis R, Robinson J, Rosal M, Wenger N, Smoller SW, Antidepressant use and risk of incident cardiovascular morbidity and mortality among postmenopausal woman in the Women’s Health Initiative study, Arch Intern Med, 2009, 169, 2128-2139. 20）Zhang Y, Souverein PC, Gardarsdottir H, van den Ham HA, Maitland-van der Zee AH, de Boer A, Risk of major bleeding among users of direct oral anticoagulants combined with interacting drugs: a population-based nested case-control study, Br J Clin Pharmacol, 2020, 86, 1150-1164. 25）Renoux C, Vahey S, Dell’Aniello S, Boivin JF, Association of selective serotonin reuptake inhibitors with the risk for spontaneous intracranial hemorrhage, JAMA Neurol, 2017, 74, 173-180. 27）Shen AY, Yao JF, Brar SS, Jorgensen MB, Chen W, Racial/Ethnic Differences in the Risk of Intracranial Hemorrhage Among Patients With Atrial Fibrillation, J Am Coll Cardiol, 2007, 50, 309-315. |
| References_xml | – reference: 9）Foerster KI, Hermann S, Mikus G, Haefeli WE, Drug-drug interactions with direct oral anticoagulants, Clinical Pharmacokinetics, 2020, 59, 967-980. – reference: 8）Galgani A, Palleria C, Iannnone LF, De Sarro G, Giorgi FS, Maschio M, Russo E, Pharmacokinetic interaction of clinical interest between direct oral anticoagulants and antiepileptic drugs, Front Neurol, 2018, 9, 1067-1076. – reference: 16）Laporte S, Chapelle C, Caillet P, Beyens M, Bellet F, Delavenne X, Mismetti P, Betoletti L, Bleeding risk under selective serotonin reuptake inhibitor (SSRI)antidepressants: a meta-analysis of observational studies, Pharmacol Res, 2017, 118, 19-32. – reference: 30）Hackett ML, Yapa C, Parag V, Anderson CS, Frequency of depression after stroke: a systematic review of observational studies, Stroke, 2005, 36, 1330-1340. – reference: 6）Konstantinides SV, Torbicki A, Angelli G, Danchin N, Fitzmaurice D, Galie N, Gibbs JS, Humbert M, Kucher N, Lang I, Lankeit M, Lekakis J, Maack C, Mayer E, Meneveau N, Perrier A, Pruszczyk P, Rasmussen LH, Schindeler TH, Scitil P, Vonk Noordegraaf A, Zamorano JL, Zompatori M, Take force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC), Eur Heart J, 2014, 35, 3033-3069. – reference: 24）Jiang HY, Chen HZ, Hu XJ, Yu ZH, Yang W, Deng M, Zhang YH, Ruan B, Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding: a systematic review and meta-analysis, Clin Gastroenterol Hepatol, 2015, 13, 42-50. – reference: 18）Schalekamp T, Klungel OH, Souverein PC, Boer AD, Increased bleeding risk with concurrent use of selective serotonin reuptake inhibitors and coumarins, Arch Intern Med, 2008, 168, 180-185. – reference: 28）Shimada K, Hasegawa S, Nakao S, Mukai R, Sasaoka S, Ueda N, Kato Y, Abe J, Mori T, Yoshimura T, Kinosada Y, Nakamura M, Adverse reaction profiles of hemorrhagic adverse reactions caused by direct oral anticoagulants nalyzed using the Food and Drug Administration Adverse Event Reporting System (FAERS) database and the Japanese Adverse Drug Event Report (JADER) database, Int J Medical Sci, 2019, 16, 1295-1303. – reference: 4）Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounaemaux H, Huisman M, King CS, Morris TA, Sood N, Stevens SM, Vintch JRE, Wells P, Woller SC, Moores L, Antithrombotic therapy for VTE disease: CHEST guideline and export panel report, Chest, 2016, 149, 315-352. – reference: 22）Eikelboom JW, Wallentin L, Connolly SJ, Ezekowitz M, Healey JS, Oldgren J, Yang S, Alings M, Kaatz S, Hohnloser SH, Diener HC, Franzosi MG, Huber K, Reilly P, Varrone J, Yusuf S, Risk of bleeding with 2 dose of dabigatran compared with warfarin in older and younger patients with atrial fibrillation. An analysis of the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial, Circulation, 2011, 123, 2363-2372. – reference: 21）Lincoff AM, Bittl JA, Harrington RA, Feit F, Kleiman NS, Jackman JD, Sarembock IJ, Cohen DJ, Spriggs D, Ebrahimi R, Keren G, Carr J, Cohen EA, Betriu A, Desmet W, Kereiakes DJ, Rutsch W, Wilcox RG, Feyter PJ, Vahanian A, Topol EJ, Blockade compared with heparin and planned glycoprotein Ⅱb/Ⅲa blockade during percutaneous coronary intervention, JAMA, 2003, 289, 853-863. – reference: 10）National Institute for Health and Care Excellence. Depression in adults: recognition and management. Clinical guideline 90, 2009, last updated April 2016. – reference: 15）Smoller J, Allison M, Cochrane B, Club J, Perlis R, Robinson J, Rosal M, Wenger N, Smoller SW, Antidepressant use and risk of incident cardiovascular morbidity and mortality among postmenopausal woman in the Women’s Health Initiative study, Arch Intern Med, 2009, 169, 2128-2139. – reference: 14）Dalton S, Johasen C, Mellemkjaer L, Norgard B, Sorensen H, Olsen J, Use of selective serotonin reuptake inhibitors and risk upper gastrointestinal tract bleeding: a population-based cohort study, Arch Intern Med, 2003, 163, 59-64. – reference: 2）Cabral KP, Pharmacology of the new target-specific oral anticoagulants, J Thromb Thrombolysis, 2013, 36, 133-140. – reference: 31）Caeiro L, Ferro JM, Costa J, Apathy secondary to stroke: a systematic review and meta-analysis, Cerebrovasc Dis, 2013, 35, 23-39. – reference: 1）van Gorp RH, Schurgers LJ, New insights into the pros and cons of the clinical use of vitamin K antagonists (VKAs) versus direct oral anticoagulants (DOACs), Nutrients, 2015, 7, 9538-9557. – reference: 13）Palmsten K, Diaz SH, Huybrechts K, Williams P, Michels K, Achtyes E, Mogun H, Setoguchi S, Use of antidepressants near delivery and risk of postpartum hemorrhage: cohort study of low income women in the United States, BMJ, 2013, 347, f4877. – reference: 20）Zhang Y, Souverein PC, Gardarsdottir H, van den Ham HA, Maitland-van der Zee AH, de Boer A, Risk of major bleeding among users of direct oral anticoagulants combined with interacting drugs: a population-based nested case-control study, Br J Clin Pharmacol, 2020, 86, 1150-1164. – reference: 26）Loke YK, Trivedi AN, Singh S, Meta-analysis: gastrointestinal bleeding due to interaction between selective serotonin uptake inhibitors and non-steroidal anti-inflammatory drugs, Aliment Pharmacol Ther, 2008, 27, 31-40. – reference: 27）Shen AY, Yao JF, Brar SS, Jorgensen MB, Chen W, Racial/Ethnic Differences in the Risk of Intracranial Hemorrhage Among Patients With Atrial Fibrillation, J Am Coll Cardiol, 2007, 50, 309-315. – reference: 12）Paton C, Ferrier I, SSRIs and gastrointestinal bleeding, BMJ, 2005, 331, 529-530. – reference: 3）日本循環器学会, 循環器病ガイドラインシリーズ2020年版：不整脈薬物治療ガイドライン（2020年改訂版）. https://www.j-circ.or.jp/cms/wp-content/uploads/2020/01/JCS2020_Ono.pdf, 2021年12月. – reference: 11）日本ペインクリニック学会編, “神経障害性疼痛薬物療法ガイドライン”, 改訂第2版, 真興交易, 東京, 2016, pp48-51． – reference: 7）Voukalis C, Lip GY, Shantsila E, Drug-drug interactions of non-vitamin K oral anticoagulants, Export Opin Drug Metab Toxicol, 2016, 12, 1445-1461. – reference: 25）Renoux C, Vahey S, Dell’Aniello S, Boivin JF, Association of selective serotonin reuptake inhibitors with the risk for spontaneous intracranial hemorrhage, JAMA Neurol, 2017, 74, 173-180. – reference: 5）Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, Boriani G, Castellà M, Dan G, Dilaveris P, Fauchier L, Filippatos G, Kalman J, Meir ML, Lane D, Lebeau J, Lettino M, Lip G, Pinto F, Thomas G, Valgimigli M, van Gelder IV, van Putte BV, Watkins C, 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC, Eur Heart J, 2021, 42, 373-498. – reference: 19）Lee MT, Park KY, Kim MS, You SH, Kang YJ, Jung SY, Concomitant use of NSAIDs or SSRIs with NOACs requires monitoring for bleeding, YMJ, 2020, 61, 741-749. – reference: 23）Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJGM, Lip GYH, A nove; user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the euro heart survey, CHEST, 2010, 138, 1093-1100. – reference: 17）Wallerstedt SM, Gleerup H, Sundström A, Stigendal L, Ny L, Risk of clinically relevant bleeding in warfarin-treated patients--influence of SSRI treatment, Pharmacoepidemiol Drug Saf, 2009, 18, 412-416. – reference: 29）Dworkin RH, O’Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS, Kalso EA, Loeser JD, Miaskowski C, Nurmikko TJ, Portenoy RK, Rice ASC, Stacey BR, Treede RD, Turk DC, Wallace MS, Pharmacologic management of neuropathic pain: Evidence-based recommendations, Pain, 2007, 132, 237-251. |
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| Snippet | 「緒言」直接経口抗凝固薬(direct oral anticoagulants: DOAC)はトロンビンや第Xa因子を選択的に阻害し, トロンビン産生総量の抑制や産生速度を遅延させることで抗凝固活性を示す. DOACは, ビタミンK拮抗薬であるワルファリンと比較して, prothrombin... |
| SourceID | medicalonline jstage |
| SourceType | Publisher |
| StartPage | 419 |
| SubjectTerms | bleeding risk DOAC pharmacodynamic interaction SNRI SSRI |
| Title | 抗うつ薬併用下における直接経口抗凝固薬による出血リスクの検討 |
| URI | https://www.jstage.jst.go.jp/article/jjphcs/48/9/48_419/_article/-char/ja http://mol.medicalonline.jp/library/journal/download?GoodsID=db5pharm/2022/004809/007&name=0419-0428j |
| Volume | 48 |
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| ispartofPNX | 医療薬学, 2022/09/10, Vol.48(9), pp.419-428 |
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