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New Anticlotting Drugs in the Works

Studies Show Apixaban and Xarelto Are Effective at Preventing Deadly Blood Clots

Xarelto Prevents Deadly Leg Clots

The Xarelto study looked at preventing deadly blood clots in the legs, a condition known as deep vein thrombosis, or DVT.

The study was designed to show that it worked at least as well as standard treatment, and that goal was met.

The standard treatment of injecting Lovenox followed by warfarin pills is "quite effective, but cumbersome to use," says researcher Harry R. Buller, MD, of the Academic Medical Center in Amsterdam.

In the late-stage phase III study, 2.1% of patients on Xarelto suffered recurrent clots, compared with 3% on standard treatment.

While the difference was so small it could have been due to chance, "Xarelto came close to demonstrating superiority," Buller tells WebMD.

The rate of major bleeds, the primary safety concern, was the same in both groups: 8.1%. And there was no evidence the new drug caused liver problems, which also had been a worry, Buller says.

"This simple single drug approach provides patients with an attractive alternative for the prevention and treatment of deep vein thrombosis," he says.

The Xarelto trial was funded by its maker, Bayer Schering Pharma.

New Anticlotting Drugs: Experts Comment

Upon hearing the data, American College of Cardiology President Ralph Brindis, MD, of Kaiser Permanente in San Francisco, says, "Patients and physicians alike have been looking for a [warfarin alternative] that doesn't require testing, is simple to use, and is safe and effective for the treatment of DVT and for the prevention of stroke in AF."

"These drugs appear to meet that need," he tells WebMD.

Harald Darius, MD, ofVivantes Neukoelln Medical Center in Berlin, who was asked to put the findings into perspective for attendees, notes that questions remain.

"I'm positive we are facing a new era of antithrombotic therapy in patients with DVT, but with some questions to be resolved. For example, what is the optimal duration of treatment? Is it three months, six months, 12 months, or even 24 months?" he says.

New Anticlotting Drugs: How They Work

The new drugs are part of a class called factor Xa inhibitors. They interfere with the body's clotting mechanism.

When we get a cut, the body calls on a blood clotting pathway to stop the bleed, Brindis explains. "But if it gets out of control, problems develop: clots in the leg that can travel to the lung, or strokes in the setting of AF.

"Interfering with this normal clotting mechanism will minimize the risk of these problems. The downside is an increase in the risk of unwanted bleeds, so it was reassuring that was not observed," Brindis tells WebMD.

No price has been set for either drug in the U.S, according to company spokespeople. Both companies hope their drugs will eventually be approved for both uses: strokes in AF patients and DVT.

These studies were presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

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