New blood thinner beats older drug for vein clots

February 20, 2013 by Steven Reinberg, Healthday Reporter
New blood thinner beats older drug for vein clots: study
But Pradaxa costs more than warfarin, and bleeding may be harder to stop, expert says.

(HealthDay)—People who need to take a blood thinner because they've had a clot in the deep veins of their legs appear to do better with the new drug Pradaxa (dibigatran) than with the older drug warfarin, researchers report.

Long-term treatment of these blood clots is safer and more convenient with Pradaxa than , the new study found.

Extended treatment with after clots develop in the veins or the lungs should be considered more often than it is, said lead researcher Dr. Sam Schulman, a professor in the division of and thromboembolism at McMaster University in Hamilton, Ontario, Canada.

If a clot in the leg breaks loose and travels to the heart, brain or lungs, it can cause a , stroke or a —all of which can be fatal.

People taking warfarin need periodic blood tests to be sure they aren't getting too much of the drug, which raises the risk of major bleeding, or too little, which is ineffective.

Pradaxa also has a lower risk of bleeding than warfarin, Schulman said, and the bleeding that does occur is less serious than that seen with warfarin, he added.

For the study, published Feb. 21 in the , Schulman's team conducted two studies of more than 2,800 patients, average age 56, who had clots in the legs, also known as venous . In one, Pradaxa was compared with warfarin, and in the other Pradaxa was compared with placebo.

In the Pradaxa-warfarin comparison, the researchers found that 1.8 percent of patients taking Pradaxa had recurrent clots, compared with 1.3 percent of patients taking warfarin. Fewer patients taking Pradaxa, however, had major bleeding (13) compared with those taking warfarin (25).

In the study comparing Pradaxa with a placebo, three patients taking the drug developed clots, compared with 37 patients taking placebo.

In this group, two patients taking Pradaxa developed major bleeding, while none in the did, the researchers added.

The trials were paid for by Boehringer Ingelheim, the maker of Pradaxa.

"These new anticoagulants are great and appear to be as effective as the only other oral one out there, warfarin," said Dr. Jean Connors, medical director of the anticoagulation management service at Brigham and Women's Hospital and Dana-Farber Cancer Institute in Boston.

They do, however, still have the risk of bleeding associated with them, said Connors, who wrote an accompanying journal editorial. "But they are easier to take because you don't need blood tests," she said.

Antidotes to bleeding caused by Pradaxa are in the works, Connors said. "With warfarin, bleeding can be reversed within half an hour, whereas with these drugs there is no good specific reversal for them," she said.

Cost of treatment is a consideration, too. Although Pradaxa is a lot more expensive than warfarin up front, when the associated costs of monitoring are accounted for, the two drugs appear to run about the same, Connors said.

"Warfarin is an extremely cheap drug, costing anywhere from $5 to $10 a month, and co-pays for Pradaxa are anywhere from $25 to $50 a month," she said.

Some cautions may be in order, however. Recently, the U.S. Food and Drug Administration said in a warning that Pradaxa should not be used to prevent stroke or in patients with mechanical heart valves.

The agency noted that a clinical trial in Europe was halted because patients taking Pradaxa were more likely to suffer strokes, heart attacks and clots forming on their mechanical heart valves than patients taking warfarin.

Explore further: FDA: Pradaxa not for patients with mechanical heart valves

More information: For more information on deep venous thrombosis, visit the U.S. National Library of Medicine.

Related Stories

FDA: Pradaxa not for patients with mechanical heart valves

December 21, 2012
(HealthDay)—The blood thinner Pradaxa should not be used to prevent stroke or blood clots in patients with mechanical heart valves, the U.S. Food and Drug Administration said in a warning issued Wednesday.

New blood thinner may help prevent leg clots, study finds

December 10, 2012
(HealthDay)—The new anti-clotting drug apixaban (Eliquis) appears to help prevent potentially fatal blood clots in patients with deep vein thrombosis (DVT), a new Italian study finds.

Bristol-Myers, Pfizer's Eliquis approved in Japan

December 26, 2012
Regulators in Japan have approved sales of an anticlotting drug called Eliquis, developed by Bristol-Myers Squibb Co. and Pfizer Inc., that's a potential blockbuster in a new category of medicines to prevent strokes and heart ...

Aspirin may prevent recurrence of deep vein blood clots

May 23, 2012
(HealthDay) -- After suffering a type of blood clot called a venous thromboembolism, patients usually take a blood-thinner such as warfarin (Coumadin). But aspirin may do just as well after a period of time, according to ...

Clot-busting drug safe for stroke patients taking blood thinner

May 10, 2012
Acute ischemic stroke patients taking the blood thinner warfarin can be treated safely with the clot-busting drug tissue plasminogen activator (tPA), according to research presented at the American Heart Association's Quality ...

Recommended for you

Study suggests ending opioid epidemic will take years

July 20, 2017
The question of how to stem the nation's opioid epidemic now has a major detailed response. A new study chaired by University of Virginia School of Law Professor Richard Bonnie provides extensive recommendations for curbing ...

Team-based model reduces prescription opioid use among patients with chronic pain by 40 percent

July 17, 2017
A new, team-based, primary care model is decreasing prescription opioid use among patients with chronic pain by 40 percent, according to a new study out of Boston Medical Center's Grayken Center for Addiction Medicine, which ...

Private clinics' peddling of unproven stem cell treatments is unsafe and unethical

July 7, 2017
Stem cell science is an area of medical research that continues to offer great promise. But as this week's paper in Science Translational Medicine highlights, a growing number of clinics around the globe, including in Australia, ...

Popular heartburn drugs linked to higher death risk

July 4, 2017
Popular heartburn drugs called proton pump inhibitors (PPIs) have been linked to a variety of health problems, including serious kidney damage, bone fractures and dementia. Now, a new study from Washington University School ...

Most reproductive-age women using opioids also use another substance

June 30, 2017
The majority of reproductive-age and pregnant women who use opioids for non-medical purposes also use at least one other substance, ranging from nicotine or alcohol to cocaine, according to a University of Pittsburgh Graduate ...

At-risk chronic pain patients taper opioids successfully with psychological tools

June 28, 2017
Psychological support and new coping skills are helping patients at high risk of developing chronic pain and long-term, high-dose opioid use taper their opioids and rebuild their lives with activities that are meaningful ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.