New Anticoagulants on the horizon (Factor XI)

[tommyboy14]

Hi Team,

Although the Proact Xa trial failed, it looks like there are now new Anticoagulants on the horizon which cause less bleeding. They are only in clinical trials now, so we will not know for a couple of years how they even compare to Apixaban. However, if this comes through, I wouldnt be surprised if On-X or somebody else try another clinical trial with this new generation of Anticoagulants.

Clinical Pharmacology of Factor XI Inhibitors: New Therapeutic Approaches for Prevention of Venous and Arterial Thrombotic Disorders

Bleeding is the dominant adverse event of anticoagulation and often discourages many patients and physicians from starting treatment with anticoagulant drugs. The fact that factor (F)XI deficiency is associated with a mild bleeding phenotype and that ...

www.ncbi.nlm.nih.gov

Perhaps this will a substitute for Warfarin one day, but we will probably not know for at least another 10 years or so...

Happy new year everybody

Tommyboy

 

[Protimenow]

When I started using the name Protimenow on this forum about a decade ago, I got a call from the product manager (or an executive) at the company that manufactured the Protime machine. He was concerned about trademark issues.

He also predicted that 'within about five years' there will be other anticoagulants that may make testing with a meter unnecessary.

He was wrong (maybe he was aware of some of the anticoagulants that were specifically NOT for people with prosthetic valves).

While it may be possible that one day there will be a medication that maintains INR at a desired level, without requiring testing, the medication will probably be extremely expensive (maybe $8 or so a pill, taken daily). I'll probably stick with warfarin (maybe 20 or 30 cents per day) and regular self-testing.

Warfarin is well known. It's a really old medication. They know how to reverse its effects quickly, if necessary. Management is understood (by some people, but few doctors), and it will probably be anticoagulant of choice until drug reps (detail people) convince prescribing doctors that it's the best way to manage anticoagulation.

I won't hold my breath for an anticoagulant for valvers, and it will probably be decades before such a drug is affordable.