An experimental drug, apixaban (Eliquis), appears better than the old standby warfarin in preventing strokes in people with the abnormal heart rhythm called atrial fibrillation, a new study finds.
Over 2.6 million Americans are affected by atrial fibrillation, and many take warfarin (also known as Coumadin) to prevent dangerous clots that can cause a stroke. Warfarin is notoriously tricky to modulate, however, and needs to be closely monitored – usually through monthly doctors’ visits. If the drug’s activity isn’t checked regularly it can trigger severe bleeding episodes, the most serious of which can happen in the brain.
“Warfarin is labor-intensive to manage,” said study researcher Dr. Jack Ansell, chairman of the department of medicine at Lenox Hill Hospital in New York City. “Sometimes it impairs the patient’s quality of life and the outcomes are very dependent on how well the drug dosing is managed,” he added. “This [new] drug has a lot of advantages over warfarin.”
With apixaban, patients can use a standard dose that doesn’t need monitoring and adjusting, Ansell said. Also, unlike warfarin, apixaban has few interactions with other drugs or foods, he added.
The study was funded by Bristol-Myers Squibb and Pfizer, the makers of apixaban.
Apixaban is a so-called Xa inhibitor, a class of anticoagulants (anti-clotting drugs) that work by blocking factor X, a protein involved in blood clotting. Ansell expects drugs in this class will have a major effect on how atrial fibrillation is managed in the future.
Another similar drug, Pradaxa (dabigatran), has been on the market for about a year and many patients with atrial fibrillation have been switched or started on it, he said.