Warfarin Treatment Seen As Superior to Pradaxa
The Chairman of the Department of Medicine at Lenox Hill Hospital in New York City is suggesting that warfarin may be a more effective blood thinning medication than newer ones like Pradaxa.
Speaking at the annual meeting of the American College of Cardiology, Dr. Jack Ansell took issue with a “knee-jerk” trend he was noticing among doctors who took patients off of warfarin in favor of newer medications, such as Pradaxa. Because warfarin is most effective when it is being managed properly, he suggested that doctors ensure they are using the anticoagulant drug effectively before looking to newer drugs instead.
"Warfarin therapy is all about management. If it’s not managed well, you can compare it to anything, and anything is going to be better. And if it’s managed very well, then it’s very difficult to beat warfarin therapy," said Ansell, according to Family Practice News.
Ansell supported his assertion with a study he recently led that followed more than 29,000 warfarin patients who had enrolled in a self-test support service. The patients who self-tested on close to a weekly basis had a mean time spent in the therapeutic INR range (TTR) of 74 percent.
He added that while a 2009 trial of Pradaxa featured a control group of warfarin patients that only had a TTR of 64 percent, patients who took warfarin did not have their dosing monitored and tracked effectively.
"This is important because the cost-effectiveness analyses done with dabigatran and the other new anticoagulants suggest that when you get up to a TTR above 70 percent with warfarin, the cost-effectiveness of the new agents diminishes and warfarin actually becomes more cost-effective," Ansell explained.
Another downside to using newer anticoagulant medications such as Pradaxa is the risk the medication may lead to a dangerous medical event. While warfarin has a history or poor drug interactions, it has been around long enough that most of its side effects have been documented. In addition to any unknown dangers that Pradaxa may pose, it has also been linked to a number of adverse bleeding events in the short time it has been available in the U.S.