Boehringer Wins FDA Approval for First Warfarin Rival

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ks1490

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fyi....good news for mech valvers....

Boehringer Wins FDA Approval for First Warfarin Rival (Update1)2010-10-19 22:10:12.105 GMT (Updates with comments from agency in eighth paragraph.)

By Naomi Kresge and Catherine LarkinOct. 19 (Bloomberg) --

Boehringer Ingelheim GmbH won U.S.regulatory approval to sell Pradaxa, a drug that may change theroutines of millions of patients who now rely on the half-century-old blood thinner warfarin.The Food and Drug Administration cleared the drug for patients with an irregular heartbeat that may raise the risk of a stroke, the agency said today in a statement.

Boehringer, the world’s biggest family-owned drugmaker,beat Pfizer Inc., Bristol-Myers Squibb Co., Bayer AG and Johnson& Johnson to win U.S. approval for a warfarin replacement, a market Bayer has said may reach $12 billion to $15 billion ayear.

The Boehringer pill is better than warfarin, whichrequires regular blood tests to ensure a safe, effective dose,most of the members of an FDA advisory panel said in September.Pradaxa sets “an extremely high bar” for competitors,Seamus Fernandez, a Boston-based analyst for Leerink Swann &Co., wrote in a note to investors on Oct. 11.

Doctors have relied on aspirin and warfarin, developed as arat poison and approved as a medicine in June 1954, to ward offstrokes in 2.2 million Americans with the irregular heartbeatknown as atrial fibrillation. Because of fears of spontaneousbleeding, a known side effect of blood thinners, some patientsaren’t being treated at all, Steven Nissen, head of cardiologyat the Cleveland Clinic, said in the advisory panel meeting.

Pradaxa is already sold in Europe to prevent clots afterhip and knee surgery, as is another potential warfarinreplacement, Bayer and J&J’s Xarelto.The FDA approved the medicine in 75-milligram and 150-milligram capsules, the agency said in its statement.“Unlike warfarin, which requires patients to undergoperiodic monitoring with blood tests, such monitoring is notnecessary for Pradaxa,” Norman Stockbridge, director of thedivision of cardiovascular and renal products for the FDA’sCenter for Drug Evaluation and Research.Bayer, based in Leverkusen, Germany, and New Brunswick, NewJersey-based J&J are expected to present results of a trial ofXarelto against warfarin in atrial fibrillation patients at theAmerican Heart Association conference in November.

Pfizer and Bristol-Myers, both based in New York, aretesting a third experimental warfarin replacement calledapixaban. The two U.S. drugmakers are expected to present trialresults comparing apixaban and warfarin next year.Warfarin replacement will be such a big market that each ofthe competitors may exceed $1 billion in annual sales ifapproved, Fernandez wrote.
 
Two points need to be emphasized for Heart Valve Patients:

1 - this drug was approved ONLY for patients with "Irregular Heartbeat" (presumably Atrial Fibrilation which is the Primary reason for prescribing anticoagulation for patients). It will take some time before it is approved for Heart Valve Patients (if ever). EDIT - Does anyone know if there are any Studies of this drug being conducted on Mechanical Heart Vale Patients ?

2 - according to my Coumadin Clinic CRNP, there is NO ANTIDOTE for this drug.
(My non-professional GUESS is that if you have a bleeding issue while on this drug, you just have to 'wait it out' until if's efficacy wears off. I'll stick with my Warfarin, Thank You.)
 
Two points need to be emphasized for Heart Valve Patients:

1 - this drug was approved ONLY for patients with "Irregular Heartbeat" (presumably Atrial Fibrilation which is the Primary reason for prescribing anticoagulation for patients). It will take some time before it is approved for Heart Valve Patients (if ever).

2 - according to my Coumadin Clinic CRNP, there is NO ANTIDOTE for this drug.
(My non-professional GUESS is that if you have a bleeding issue while on this drug, you just have to 'wait it out' until if's efficacy wears off. I'll stick with my Warfarin, Thank You.)



Al..... Isn't this new drug good news for a tissue valver who develops a-fib?

I know very little (nothing) re: Plavix. What happens if one has a bleeding episode if they take that drug?
 
At a minimum it appears the pipeline is moving in the right direction!

This *may be* good news for patients with A-Fib.

Without studies being conducted on patients with Mechanical Valves, it will be a LONG TIME before it will even be considered for approveal for patients with Mechanical Heart Valves. Does anyone know if those studies are being conducted?

'AL Capshaw'
 
Does anyone know what treatment is used if a patient taking Plavix (prescribed after placement of stents) has a bleed? Is there an antidote?

Thanks if you know anything about this.
 
This *may be* good news for patients with A-Fib.

Without studies being conducted on patients with Mechanical Valves, it will be a LONG TIME before it will even be considered for approveal for patients with Mechanical Heart Valves. Does anyone know if those studies are being conducted?

'AL Capshaw'

So far there are NO trials for Mechanical valves and Pradaxa, (also called dabigatran there are a couple threads talking about it a few months ago here by either of those names) beside the A Fib trials, There also have been trials for right after hip or knee replacements http://www.hemonctoday.com/article.aspx?rid=66449 I haven't even seen it being discussed for mech valves in Europe either so I imagine it will be quite a while (YEARS), if ever, before it replaces Coumadin for mech valvers.

You take it 2 times a day, because it has a pretty short 1/2 life (around 12 hours?) Which probably helps a little in traumas or emergency surgeries since it doesn't stay around as long as Coumadin ect.

Here is an interesting article about the approval, http://www.theheart.org/article/1123797.do One of the concerns is how expensive will it be
 
So far there are NO trials for Mechanical valves and Pradaxa, (also called dabigatran there are a couple threads talking about it a few months ago here by either of those names) beside the A Fib trials, There also have been trials for right after hip or knee replacements http://www.hemonctoday.com/article.aspx?rid=66449 I haven't even seen it being discussed for mech valves in Europe either so I imagine it will be quite a while (YEARS), if ever, before it replaces Coumadin for mech valvers.

You take it 2 times a day, because it has a pretty short 1/2 life (around 12 hours?) Which probably helps a little in traumas or emergency surgeries since it doesn't stay around as long as Coumadin ect.

Here is an interesting article about the approval, http://www.theheart.org/article/1123797.do One of the concerns is how expensive will it be

I pay $10 for 90 tablets of Generic Warfarin which works out to 11 Cents per tablet. This rate is available at CVS, Walmart, and other pharmacies that have special Generic Medication pricing.
 
Anything that pushes new anticoagulation methods forward is a good thing in my book, even if a warfarin replacement for valvers is a long ways away.
 

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