Current Blood Thinners Face Tough Competition

Studies provide more evidence that newcomers hold mettle against warfarin, aspirin

By Amanda Gardner
HealthDay Reporter

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FRIDAY, Feb. 26 (HealthDay News) -- New studies provide more proof that the mainstays of anti-clotting therapy, namely warfarin and aspirin, are facing some severe competition from newcomers.

Researchers presenting their findings during a Friday news conference at the American Stroke Association's annual meeting in San Antonio show that one new drug, dabigatran (Pradaxa), which is not yet approved in the United States, equaled warfarin for treating stroke patients, while cilostazol (Pletal), which has been approved by the U.S. Food and Drug Administration for the treatment of peripheral arterial disease (PAD), outperformed aspirin in preventing recurrent strokes.

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Other researchers presented evidence that high-intensity movement exercise assisted by a robot or a human can improve functioning and quality of life in stroke survivors years after the event. It has long been thought that improvements could only be garnered in the early days following a stroke.

The Pradaxa trial included 3,623 patients with atrial fibrillation and a previous stroke who were randomized to receive warfarin, a low dose of Pradaxa (110 milligrams) twice a day or a higher dose (150 mg) of Pradaxa twice a day for about two years.

The rate of stroke or transient ischemic attack (TIA) in those taking warfarin was 2.74 percent a year and 2.32 percent a year for those taking Pradaxa, not a significant difference.

The lower dose of Pradaxa also caused less bleeding and was easier to manage than warfarin, a famously difficult drug to administer and monitor.

"In contrast to warfarin, dabigatran is given in a fixed dose twice daily independent of body weight, sex, food, whatever, and you don't need to monitor the coagulation system," study author Dr. Hans-Christoph Diener, chairman of neurology at University Hospital in Essen, Germany, said during the news conference.

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