New frontiers in the management of arterial thrombosis with oral anticoagulants
2008 (English)In: Thrombosis and Haemostasis, ISSN 0340-6245, Vol. 100, no 6, A15-A19 p.Article in journal (Refereed) Published
Atrial fibrillation (AF) is the most common cardiac arrhythmia, and its prevalence increases substantially with age. As patients with AF have an almost five-fold greater risk of stroke than those without AF, stroke prevention in AF (SPAF) represents a key therapeutic goal. The current standard of therapy for SPAF involves treatment with a vitamin K antagonist or aspirin; however, these agents are associated with important limitations that restrict their uptake and effective use. There are currently intense efforts to develop a new, effective, and safe antithrombotic treatment for use in SPAF, with research focusing on oral direct thrombin inhibitors (DTIs; e.g. dabigatran etexilate) and factor Xa inhibitors (e.g. apixaban, rivaroxaban). Of these, the oral DTI, dabigatran etexilate, is the most advanced in clinical development. The phase II PETRO study and its long-term extension trial, PETRO-Ex, together formed the basis for the ongoing phase III RE-LY (TM) trial, which is comparing the efficacy of two blinded doses of dabigatran etexilate (110 mg bid and 150 mg bid) with that of open-label warfarin in SPAF for a treatment duration of up to three years. Results are expected in 2009. An ongoing phase 11 dose-finding, safety, and tolerability study (RE-DEEM (TM)) is also assessing dabigatran etexilate in the secondary prevention of cardiac events in post-index myocardial infarction patients. It is expected that the results of this trial will guide the selection of an appropriate dose for further clinical testing in this indication.
Place, publisher, year, edition, pages
2008. Vol. 100, no 6, A15-A19 p.
Anticoagulants, atrial fibrillation, dabigatran etexilate, stroke
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-152152ISI: 000261880900014OAI: oai:DiVA.org:uu-152152DiVA: diva2:412686