StopAfib.org interviews Dr. Daniel Singer of Harvard Medical School.
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Dr. Singer led a symposium on atrial fibrillation stroke prevention at Boston Atrial Fibrillation Symposium 2012. In this video interview, Dr. Singer shared with StopAfib.org information from that symposium. He provided an update on rivaroxaban (Xarelto), which was recently approved by the FDA, and talked about the results of the two trials of apixaban (Eliquis), AVERROES and ARISTOTLE, against aspirin and warfarin, respectively. He also mentioned edoxaban, which should finish trials in 2012, and that we now have a year of results in clinical practice with dabigatran (Pradaxa). He also mentioned that the new drugs have all shown better results than warfarin (Coumadin) in preventing intracranial bleeding (bleeding in the brain). He confirmed that patients will have a lot of new choices soon, but that cost will continue to be an issue.
Dr. Singer is a Professor of Medicine at Harvard Medical School, Professor of Epidemiology at the Harvard School of Public Health, and Chief of the Clinical Epidemiology Unit at Massachusetts General Hospital.
I know that Pradaxa has no reversal agent for bleeding: won’t this cause an issue all types of bleeds and not just cerebral hemorrhages? Do the other new drugs have an antidote?
None of the new drugs have reversal agents yet. However, all have a much shorter half-life than warfarin, so their effect doesn’t last nearly as long. And the reversal agent for warfarin doesn’t work instantly, and doesn’t always work. Thus warfarin has a higher rate of bleeds and deaths than the new agents.
The reason there is so much hype around the new drugs and no one complains about the old ones is that the drug companies putting out the new drugs have deep pockets that a lot of folks are trying to tap into. For this reason, there is so much hype out there, and so many journalists stirring up controversy to get their articles read, so please be careful of what you read and don’t believe half of it.