There is a lot of appropriate interest and excitement today about one of the four new oral anticoagulants in development – Apixaban (Eliquis). Data from the large ARISTOTLE trial were published today in the NEJM, showing that in patients with atrial fibrillation Apixaban was more effective in preventing stroke and systemic thromboembolism, caused less major bleeding, and resulted in lower mortality than warfarin in patients with non valvular atrial fibrillation [ref 1]. This is good news.The results and publication have, however, no immediate impact on patients and practicing health care professionals, as the drug still needs to go through the FDA approval process. In addition, relevant to the Clot Connect mission – providing information and education about DVT and PE – the clinical trial comparing Apixaban to warfarin in patients with DVT/PE – AMPLIFY trial – is still ongoing (see table 1 here).
Atrial Fibrillation and Apixaban
The reader interested in atrial fibrillation can find summarizing relevant information as it relates to the ARISTOTLE atrial fibrillation trial here. Also, the full study publication is available as an ePub on the web ahead of print in the New England Journal of Medicine [ref 1].
The New Anticoagulants
The four new oral anticoagulant drugs that are at present of most relevance to the clinician are (a) Pradaxa® (Dabigatran), (b) Xarelto® (Rivaroxaban), (c) Eliquis® (Apixaban), and (d) Savaysa® (Edoxaban). Clinical-practical relevant information on these drugs is discussed in various Clot Connect blogs. A summarizing table of the clinical trials, publications and FDA approval status can be found here (see table 1 here).
1. Granger CB et al. N Engl J Med, Aug 29 2011 (ePub ahead of print).
Disclosure: I have consulted for OthoMcNeil and Bayer, the companies developing Xarelto.
Last updated: Aug 28th, 2011
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