Clotblog with Dr Samuel Goldhaber

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Clear the decks for apixaban!

Jun 24, 2011 16:55 EDT


As the population ages and atrial fibrillation becomes more common, the news that another drug—apixaban—has made its first step toward joining the growing field of novel anticoagulants is cause for celebration. What are your thoughts on the preliminary results of the ARISTOTLE trial, which have shown apixaban to be noninferior to warfarin for stroke prevention in AF patients?

See:

ARISTOTLE: Apixaban noninferior to warfarin in AF patients

Connolly SJ, Eikelboom J, Joyner C, et al.  Apixaban in patients with atrial fibrillation. N Engl J Med 2011; 9:806-817. Available here.

Bristol-Myers Squibb. Eliquis (apixaban) meets primary and key secondary endpoints in phase 3 ARISTOTLE study [press release]. June 22, 2011. Available here.





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Your comments
Clear the decks for apixaban!
# 1 of 3
June 26, 2011 11:24 (EDT)
Dennis G Brown,MD
Is there some reason that Dabigatrin and Apixaban were studied in non-valvular AF patients? What is now the treatment in valvular AF? Warfarin?
# 2 of 3
June 29, 2011 04:38 (EDT)
SZG
None of the novel anticoagulants have been studied in populations of patients with AF due to valvular heart disease.  Perhaps this is the next logical step after establishing efficacy and safety of these agents in nonvalvular AF.  Your comment is insightful.--SZG
# 3 of 3
July 10, 2011 07:02 (EDT)
Dr. Nabil Kamas

For AF with valvular heart disease warfarin is still the only oral anticoagulant available.

The strategy for drug makers is that they first test their drug in less comlicated conditions, get it FDA approved, make some return on their investments, then years later test it on more complicated conditions to expand their market share.

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Who's Talking
Samuel Z Goldhaber, MD
Professor of Medicine
Harvard Medical School
Director, Venous Thromboembolism Research Group
Co-Director, Anticoagulation Management Service
Cardiovascular Division
Brigham and Women's Hospital
Boston, MA