In 2010, the first novel oral anticoagulants (NOACs) hit the market to compete against the long-used warfarin for the prevention of strokes in patients with non-valvular atrial fibrillation (Afib). Since then, almost half of the newly diagnosed Afib patients in the GLORIA-AF international registry were treated with NOACs.
The data came from the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) registry, an international registry spanning five continents and involving more than 15,000 patients enrolled within three months of their Afib diagnosis between 2011 and 2014.
Overall, nearly a third of registry patients were treated with vitamin K antagonists (warfarin), another 12 percent received aspirin or another antiplatelet medication, and 7.8 percent received no antithrombotics at all.
The rate of NOAC use in both the U.S. and Europe exceeded 50 percent at 52.1 percent and 52.3 percent, respectively. In Asia, the rate fell to 27.2 percent, just below warfarin at 27.5 percent.
NOACs, which include Pradaxa, Xarelto and Eliquis, are promoted as more convenient alternatives to warfarin because patients taking the newer blood thinners do not need to be monitored on a regular basis as they do with warfarin. However, major bleeding is a risk factor with all blood thinners. And there is no antidote for the best-selling NOAC, Xarelto, and its closest rival, Eliquis, to reverse the bleeding effects of the drugs in the event of a bleeding emergency, such as gastrointestinal bleeds and brain bleeds.
The first trials against Xarelto makers Johnson & Johnson’s Janssen Pharmaceuticals and Bayer begin later this year accusing the companies of failing to warn doctors and patients of the bleeding risks with Xarelto and for negligently marketing the drug without an antidote.
Source: Medpage Today