Regimen Prolongs AV Graft Patency by ProQuest


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      30 Renal & Urology News               JULY 2009

       Regimen Prolongs AV Graft Patency
      Aspirin plus dipyridamole decreased the risk of primary unassisted patency loss by 18%
      BY TRACI DANTONI                           “Our trial results show that we now    “This is an important step forward      ing order so patients can get the
      A COMBINATION of aspirin and             have a drug therapy that significantly   as we proceed to develop therapies      dialysis they need,” said Griffin P.
      the antiplatelet drug dipyridamole       prolongs the viability of AV grafts,”    to improve dialysis patients’ quality   Rodgers, MD, Director of the
      can significantly decrease the risk      said lead investigator Bradley S.        of life.”                               National Institute of Diabetes and
      of patency loss in new arterioven-       Dixon, MD, Associate Professor of          “This drug combination provides a     Digestive and Kidney Diseases, which
      ous (AV) hemodialysis (HD) grafts,       Medicine at the University of Iowa       modest but important new therapy        supported the trial. “But clearly
      according to a five-year study.          College of Medicine in Iowa City.        to keep AV grafts in good work-         more research is needed to ex-
                                                                                                                                tend the useful life of AV grafts.”
                                                                                                                                Study findings appear in The New
                                                                                                                                England Journal of Medicine (2009;
                                                                                                                                  Conducted at 13 clinical sites in
                                                                                                                                the United States, the study involved
                                                                                                                                649 HD patients who recently re-
                                                                                                                                ceived an AV graft. Subjects were
                                                                                                                                randomly assigned to receive dipy-
                                                                                                                                ridamole 200 mg plus aspirin 25 mg
                                                                                                                                twice daily (321 patients) or a place-
                                                                                                                                bo (328 patients) over 4.5 years, with
                                                                                                                                six additional months of follow-up.

                                                                                                                                The combination
                                                                                                                                did not raise the
                                                                                                                                incidence of severe
                                                                                                                                adverse events.
                                                                                                                                  The median duration of patency was
                                                                                                                                5.8 months in the combined-treatment
                                                                                                                                arm compared with 4.3 months in
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