Friday, March 16, 2007
warfarin en aspirin
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Ximelagatran Comparable to Warfarin in Stroke Prevention
Reuters Health Information 2007. © 2007 Reuters Ltd.
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
NEW YORK (Reuters Health) Mar 12 - Ximelagatran compares favorably to warfarin for secondary stroke prevention in patients with atrial fibrillation. However, the combination of warfarin plus aspirin appears unsafe, researchers report in the March issue of Stroke.
Ximelagatran was withdrawn from the market and clinical development by AstraZeneca in February of last year, but the current findings suggest that other direct thrombin inhibitors may have therapeutic potential in this high-risk population.
Lead investigator Dr. Paul T. Akins told Reuters Health that this was a rigorous test of "whether oral direct thrombin inhibitors, a new class of drugs, can compete with warfarin in stroke prevention without an increase in bleeding or other adverse effects."
Dr. Akins of the Mercy Stroke Center, Sacramento, California and colleagues pooled data from two trials involving more than 7000 patients with or without a previous stroke or transient ischemic attack.
The annual rate of stroke or systemic embolic events in those who had a history of stroke was 2.83% with ximelagatran and 3.27% with warfarin. For those without prior stroke, the corresponding proportions were 1.31% and 1.26%.
"Ximelagatran proved to be quite effective at stroke prevention with a similar bleeding profile to warfarin," added Dr. Akins. "Unfortunately, adverse liver effects kept ximelagatran from market approval."
However, another key finding from this study was the hazard associated with combination aspirin/anticoagulant therapy, a common but unproven clinical practice.
"Combining low-dose aspirin with warfarin did not boost stroke prevention," continued Dr. Akins, "but bleeding jumped three-fold, from 1.5% per year to 4.95% per year."
He concluded that "combination aspirin/warfarin was not better than individual agents, and doctors need to understand it is dangerous."
Stroke 2007;38:874-880.
Ximelagatran Comparable to Warfarin in Stroke Prevention
Reuters Health Information 2007. © 2007 Reuters Ltd.
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
NEW YORK (Reuters Health) Mar 12 - Ximelagatran compares favorably to warfarin for secondary stroke prevention in patients with atrial fibrillation. However, the combination of warfarin plus aspirin appears unsafe, researchers report in the March issue of Stroke.
Ximelagatran was withdrawn from the market and clinical development by AstraZeneca in February of last year, but the current findings suggest that other direct thrombin inhibitors may have therapeutic potential in this high-risk population.
Lead investigator Dr. Paul T. Akins told Reuters Health that this was a rigorous test of "whether oral direct thrombin inhibitors, a new class of drugs, can compete with warfarin in stroke prevention without an increase in bleeding or other adverse effects."
Dr. Akins of the Mercy Stroke Center, Sacramento, California and colleagues pooled data from two trials involving more than 7000 patients with or without a previous stroke or transient ischemic attack.
The annual rate of stroke or systemic embolic events in those who had a history of stroke was 2.83% with ximelagatran and 3.27% with warfarin. For those without prior stroke, the corresponding proportions were 1.31% and 1.26%.
"Ximelagatran proved to be quite effective at stroke prevention with a similar bleeding profile to warfarin," added Dr. Akins. "Unfortunately, adverse liver effects kept ximelagatran from market approval."
However, another key finding from this study was the hazard associated with combination aspirin/anticoagulant therapy, a common but unproven clinical practice.
"Combining low-dose aspirin with warfarin did not boost stroke prevention," continued Dr. Akins, "but bleeding jumped three-fold, from 1.5% per year to 4.95% per year."
He concluded that "combination aspirin/warfarin was not better than individual agents, and doctors need to understand it is dangerous."
Stroke 2007;38:874-880.
# posted by roodbont @ 2:03 PM 
