Archive for the ‘Anticoagulants’ Category
Stephan Moll, MD writes…. Today (Jan 8th, 2015) the FDA approved yet another new oral anticoagulant, Savaysa (edoxaban), for the treatment of DVT and PE, as well as for atrial fibrillation. The FDA press release is here (link). Savaysa is the 4th of the NOACS now approved for VTE treatment. This table summarizes the differences, advantages and disadvantages comparing the 4 drugs. The detailed drug package insert with dosing information is here (link). Read the rest of this entry »
Stephan Moll, MD writes (Dec 17, 2014)… The American Society of Hematology (ASH) published last week as part of its Choosing Wisely® campaign two things that physicians dealing with DVT, PE and anticoagulants should avoid [ref 1]. Read the rest of this entry »
Stephan Moll, MD writes (on Dec 8th, 2014)… A publication this week in the New England Journal of Medicine reports on an investigational drug that protects patients from VTE without increasing the risk of bleeding [reference below]. Too good to be true? Possibly, but may be not. Additional studies will have to tell. Read the rest of this entry »
Stephan Moll, MD writes (on Nov 7th, 2014)… A N Engl J Med publication this week [ref 1] reports on a new reversal agent (PER977 = Aripazine = ciraparantag) that may be effective against a number of different new oral anticoagulants. Read the rest of this entry »
Stephan Moll, MD writes… Is there a dose change or limitation for the use of Xarelto® (rivaroxaban) in very obese or underweight patients? Read the rest of this entry »
Stephan Moll, MD writes… Aspirin is beneficial in preventing recurrent venous thromboembolism (VTE) in patients who have had a previous episode of unprovoked VTE and who have been treated with anticoagulant therapy, a publication in the journal Circulation re-confirms this week: Aspirin reduces the risk of recurrent VTE by more than a third without significantly increasing the risk of bleeding [ref 1]. This publication does not report results of a new study, but is rather a further analysis of the previously published WARFASA and ASPIRE aspirin trials [ref 2,3]. Read the rest of this entry »
Stephan Moll, MD writes… Apixaban (Eliquis®) was approved by the FDA this week (Aug 21, 2014) for the treatment of DVT and PE. The approval covers (a) acute DVT/PE management and (b) prevention of recurrent DVT/PE. Read the rest of this entry »
Stephan Moll, MD writes… Today the FDA approved Pradaxa (dabigatran) for the treatment of venous thromboembolism, based on the phase 3 RECOVER and RECOVER II trials. The dose is 150 mg twice daily for patients with a GFR > 30 ml/min. Due to the design of the RECOVER and RECOVER II trials, the drug is approved to be used in the patient with acute DVT or PE only AFTER 5-10 days of a parenteral anticoagulant have been given – not immediately from day zero onwards. The full package insert is here. The press release from Boehringer-Ingelheim is here. The FDA approval status of the four big new oral anticoagulants for the various indications is summarized in this table.
Disclosures: I have been a consultant for Boehringer-Ingelheim, Daiichi, and Janssen.
Last updated: April 7th, 2014
Stephan Moll, MD writes… LMWH (low molecular weight heparin) is the preferred anticoagulant in the pregnant patient. LMWH and warfarin are safe in the woman who is beast-feeding.
Rivaroxaban (Xarelto), dabigatran (Pradaxa) and apixaban (Eliquis) should not be used during pregnancy or while breastfeeding.
Stephan Moll, MD writes… On Dec 19th the FDA accepted the application by Bristol-Myers Squibb (BMS) and Pfizer for review of Eliquis (apixaban) for the treatment of DVT and PE. The press release of BMS is here. The goal date for a decision by the FDA is August 25, 2014. Read the rest of this entry »