Atrial fibrillation

Warfarin-replacement parade gets crowded

The dabigatran party isn’t even cleaned-up yet, when another warfarin competitor has hit the press wires.

As reported on Cardiobrief from a Bayer press release, Rivaroxaban (Xarelto) was as effective as warfarin in stroke prevention in patients’ with AF. A composite of major and minor bleeding events were also similar to warfarin.

Rivaroxaban is a FactorXa inhibitor so it works farther north in the coagulation cascade than does dabigatran.

The ROCKET-AF trial randomized 14,000 patients with AF. It is scheduled to be presented at the American Heart Association meeting in two weeks. The Bayer press release speaks of non-inferiority, not superiority. We will see, but one would have thought if it was superior, this would have been mentioned.

And there is a third player in the warfarin-replacement parade, apixaban, a FactorXa inhibitor under development by pharma-behemoths Bayer and J and J.

A new era of warfarin substitutes are here.  Progress.

Who would have thought this possible ten years ago.


Reference:  Cardiobrief:  An outstanding source of cardiovascular news.

3 replies on “Warfarin-replacement parade gets crowded”

Just out of curiosity, do you think the cost of the new Factor Xa inhibitors will justify their use as opposed to $4 warfarin, even when taking the added cost of PT/INR monitoring into consideration?

Since I used to work for big pharma, I am certainly not against them making some cash, but some new drugs do not seem to be priced on a logical pharmacoeconomic model.

A patient by patient cost-effectiveness analysis would have to include the cost of administration and monitoring of warfarin. The cost of these can be rather high for those who have moderate dementia and are not able to be in charge of their own medications and cannot drive to the lab for their blood tests. It's more than just the cost of the pill.

Comments are closed.