Study: New Anticlotting Drug Beats Warfarin
Eliquis More Effective at Preventing Strokes in Patients With Atrial Fibrillation
Atrial Fibrillation and Stroke Risk continued...
Because it works by blocking vitamin K, eating foods that are high in the nutrient, like dark leafy greens, can make warfarin less effective. Many drugs, including some antibiotics and painkillers, can interact with the drug, blocking or enhancing its effect.
As a result, only about half of patients who can benefit from the drug actually take it.
Overall, 1.3% of patients per year in the Eliquis group suffered a stroke or major blood clot vs. 1.6% per year in the warfarin group. The rate of serious internal bleeding was 2.1% per year in the Eliquis group vs. 3.1% per year in the warfarin group. And 3.5% of patients per year in the Eliquis group died vs. 3.9% per year in the warfarin group.
This means that for every 1,000 patients treated for nearly two years, Eliquis, as compared with warfarin, prevented six strokes, 15 serious bleeding episodes, and eight deaths, says study head Christopher B. Granger, MD, of Duke University Medical Center in Durham, N.C.
The benefit in stroke prevention was driven mainly by the difference in bleeding (hemorrhagic) stroke, with Eliquis preventing four hemorrhagic strokes per 1,000 patients and two clot-related (ischemic) strokes per 1,000 patients.
Eliquis bested warfarin in all subgroups of patients studied, regardless of age, gender, weight, or prior use of warfarin, among other characteristics, Granger tells WebMD.
Pros and Cons of New Drugs
The new drugs -- Eliquis, Pradaxa and Xarelto -- are all wins for patients, says Michael Bonn, MD. Bonn is chairman of the committee that chooses which studies to highlight at the meeting. He is also a cardiologist at University Hospital of Saarland in Homburg, Germany.
Bonn says the new drugs provide the same or better protection as warfarin, but without the need for frequent blood monitoring or food interactions.
There aren't any studies directly comparing the newer drugs to each other. But Eliquis appears to have some advantages over Pradaxa, which is already FDA approved for stroke prevention in AF patients, and Xarelto, which is approved for prevention of potentially deadly blood clots in the legs of patients undergoing joint replacement surgery, he tells WebMD. An FDA advisory committee is meeting next month to consider Xarelto for stroke prevention in AF.