In June it will be *hammertime* for me.....female, 65, no longer a CHADS score zero *just because* and the blood thinner conversation will happen as will the prescribing of it at my heart guy appt.....my vote is going to be for Eliquis , after much research, many *conversations* with marikay ( our paths seem to follow the same road :) and my busy lifestyle that includes both long hours at work and lack of interest in Coumadin monitoring . I am hoping the cost wont be prohibitive but I am ready and willing to make the jump into the anticoagulant pool , it will beat having a stroke anyday of the week :) Thanks for the great article Paul, it just added more conviction to my decision . jan

Good post Paul. I take Pradaxa but I think Eliquis provides the best mix of protection without bleeds. The 2% number includes the old and frail who account for most bleeds. The "absolute" numbers are not much different for all the anticoagulants. So any anticoagulant is good. Petey

I'll be 65 in August. With a history of DVT, Pulmonary Embolisms, Stroke and AFIB, it looks like anti-coagulants for life for me.

Great article, thanks for sharing, with my risk factors and family history I imagine I will be on Eliquis the rest of my life and I am okay with it.

Good read and comments.

Good article, but, ,Im still zero CHADS. I have always been a klutz, since I a kid. Broken legs, bumps, bruises, cuts, stitches, etc. Since I am getting older, my balance will get worse, the chance of falling will increase. I would not go on an NOAC, without an antidote.

Paul: Thanks for posting the article. Over the weekend I did a little research myself and this article helps confirm the conclusion I came to. I've had PEs before and with AFib I believe I need to do something.

As a trail runner, falling is inevitable. Every once in a while, a rock or root gets bored and reaches up, grabs my toe and throws me down. About 10 years ago I slipped on a rock and crushed my nose while running across a stream. I had quite a nose bleed for a couple of hours. I know the hazard.

And since I've noticed more problems with balance, I've been working with a trainer to try to reduce the risk of losing my balance.

So not having an antidote was one reason I didn't consider the NOACs. Plus the cardiologist steered me away from them for the same reason.

I've contacted my cardiologist and asked to be put on one of the NOACs, preferably Eliquis. It sounds like a better choice for me.

Todd

Here's a RECENT interesting article on NOAC antidotes.

http://healthcare.globaldata.com/resources/expert-insights/pharmaceuticals/portolas-noac-antidote-benefits-from-big-pharma-collaborations-and-phase-iii-study-initiation

The reversal agent is for factor XA drugs (Xarelto and Eliquis) being developed by Portola Pharmaceuticals. The drug is called andexanet alfa. Sounds like they are in phase 2 trials.

From the company web site:
http://www.portola.com/clinical-development/andexanet-alfa-prt4445-fxa-inhibitor-antidote/

FYI: The Pradaxa reversal agent Phase I study was completed in November:

November 18, 2013
Data from First Phase I Study of Antidote for Pradaxa (dabigatran etexilate mesylate) Presented at American Heart Association Scientific Sessions

Data indicate the antidote may be able to achieve immediate, complete and sustained reversal of dabigatran-induced anticoagulation in healthy humans

Ridgefield, CT, November 18, 2013 Boehringer Ingelheim Pharmaceuticals, Inc. today announced results showing that its investigational fully humanized antibody fragment (Fab) rapidly reversed the anticoagulation effect of dabigatran in healthy male volunteers. These results, presented today during the American Heart Associations Scientific Sessions 2013, represent the first clinical data involving the compound, which was discovered and developed by the company.

Testing is going on now.
petey

I'm adding the attached reference for completeness, however this article is a year old. PER977 looks promising because it works with all the current NOAC's (Pradaxa, Xarelto, and Eliquis). It works within 30 minutes, it is stable at room temperature, so can be carried in an ambulance. As far as I can tell, it a is stage 1 testing.

http://blogs.nature.com/spoonful/2013/03/antidotes-edge-closer-to-reversing-effects-of-new-blood-thinners.html