I thought it was going to be the same one Dr. Orange blogged about today, but it's different. I really like the idea of less bleeding risk....dunno if I'd have the guts to switch even if my insurance did cover the new drugs. Thanks for the info Toss! You always find the current news on stuff!

You can read Dr. Moll's article over at our Clot Connect website:

http://clotconnect.wordpress.com/2011/08/28/eliquis-apixaban-news-%e2%80%93-plus-update-on-the-big-four-new-oral-anticoagulants/

The table from that article gives an overview of where each medication stands (at least here in the U.S.):

http://clotconnect.files.wordpress.com/2011/08/new-summary-table-new-anticoagulants1.pdf

Regards,
Tom

Good I hope it replaces Warfarin because I hate it! Of course I'm only planning to be on Warfarin another month or two and then I'm done. Right now my ucler is acting up and I'm seriously bleeding like crazy and I don't think Warfarin is helping my cause lately.

Their off line use is DVT/PE. I'm not willing to take the chance. Once they have the research to show its a good as or better than Coumadin for DVT.PE then its a possible replacement. I may be one of the few who does not mind taking Coumadin and have had no issues with it. You have to understand there are so many body chemical reasons that people clot and have DVT. New meds have to be able to persevere beyond that.

Each of the new medications are directed as an alternative to Coumadin (DVT/PE treatment and prevention). Yes, they are targeted initially for FDA approval for smaller patient communities (Atrial Fib, Hip/Knee Replacement) for the sake of receiving prompt FDA approval. It's easier to say a medication is as safe or better then Coumadin/Lovenox when used on Knee/Hip replacement patients then to say it can be used as DVT/PE treatment and prevention which is a more broader statement and requires a lot more studies since you have to address not only DVT/PE patients but also Atrial Fib patients,surgical procedures, and other patients who rely on anticoagulation as part of their treatment. Once approved for a specific commmunity, then the company can take it's time to address the whole big picture which is DVT/PE treatment and prevention.

What is not known about these medication is long term side affects. As a life-long patient, I would be hestitant to make the switch at this point without more information regarding liver enzyme readings and such. Though there is no antidote to reverse the bleeding process like with Coumadin, there are procedures which can be taken to reduce the risk in the event of an emergency.

My thoughts are the new breed of medications will improve patient quality of life in that: (1) no INR check needed; (2) medication is fast acting; (3) No need to bridge following surgery/medical procedures. For those who don't fare well on Coumadin/Warfarin, they are a viable alternative. For long term users, there still are some unknowns regarding long-term side effects.

No INR check needed?! Thats like a dream come true. I wonder if I can sign-up anywhere to test the stuff out or does it have a release date yet?

Physicians who are involved with the trials can prescribe it to a patient. If you have thrombophilia specialist in your area, they would be a good starting point. In MO, you have the following location:

Center for Bleeding and Thrombotic Disorders**
Hemophilia Treatment Center, Adult Program
St. Louis University Hospital, West Pavilion
3635 Vista Avenue, Suite 103
St. Louis, MO 63110
Phone: 314-577-6168
Fax: 314-268-5643
Adult after hours: 314-577-8000

Dero from this message board was an original member who was on the Rivaroxaban (Xarelto) trials. He is know on the product long-term due to a subsequent clot after stopping therapeutic treatment.

Glad to have willing guinea pigs out there. I'm not one of 'em. Just because the FDA approves something doesn't mean it won't be recalled down the road. I'll wait for it to be used for oh, the next 20 or so years, just about the time my risks on warfarin will be greater due to advancing age.
Nice that alternatives are being sought though.

Tom, what procedures are available to reduce bleeding risks with the new drugs?

I test at home and frankly, other than taking a pill every day I forget I'm on coumadin 90% of my life. I am pretty active and, although there is a bleeding risk, there is an "antidote." Losing that would make me nervous

Chris

Chris, I'm with you. I kind of don't think about the warfarin much. And I don't even test at home. But now all of it, from taking the meds to going to the labs for my INR, is down to a routine. I think that's what is hard in the beginning when you're on warfarin, just figuring it all out and not getting stressed about it. I also think for us lifers, once you've surrendered to the whole " this is how it's going to be aspect," it strangly frees you a bit. Once you quit fighting it, it all falls into place, at least for me it did.

Yeah, I'm thankful for all the folks who are taking one for the team and trying the new drugs, but me, I'm alright where I am.

I could see switching to one of the newer drugs in ten years or so. I'm not worried about being on warfarin really, but I do like the idea of taking something that doesn't inhibit the Vit K absorbsion so much. Would rather not be dealing with osteoporosis because of years on warfarin. Also, we like to avoid a major bleed someday if possible, so these drugs are a step that direction too.

But yeah, until they've been tested for a few years and until there are solid reversal procedures, I'm not making the switch either!

i've been on warafrin for 41 years i'll just stick with it .i've had no problems so far

Chris, here is some information regarding bleeding management from our Clot Connect website:

http://clotconnect.wordpress.com/2010/12/06/pradaxa-management-of-major-bleeding/

I have been on, off, and back on Coumadin since 1992. I really have not problems with the medication. Yes, the new anticoagulants would elevate the monthly INR checks but it will be a while before I would consider them for long-term use.

Thanks Tom