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The case for dosing dabigatran: how tailoring dose to patient renal function, weight and age could improve the benefit-risk ratio
Dabigatran is increasingly being used in clinical practice for the thromboprophylaxis in atrial fibrillation as a convenient therapy that needs no drug level monitoring. However, analysis of the data of the same clinical trial that led to the adoption of dabigatran in fixed-dosing regimens has indicated a small subgroup of patients that could be either over-treated, risking bleeding, or under-treated, risking embolism. Additional post-marketing data lends support to the favorable therapeutic profile of dabigatran but at the same time raises doubts about patient characteristics such as weight, age, renal function and their ...
Source: Therapeutic Advances in Neurological Disorders - October 27, 2015 Category: Neurology Authors: Safouris, A., Triantafyllou, N., Parissis, J., Tsivgoulis, G. Tags: Reviews Source Type: research

Reservations against new oral anticoagulants after stroke and cerebral bleeding
Abstract: Dabigatran, rivaroxaban, and apixaban are the new oral anticoagulants (NOAC) which have been investigated in patients with atrial fibrillation (AF) for primary and secondary prevention of stroke and thromboembolism. In these trials NOAC had a similar efficacy and safety profile compared to traditional vitamin-K-antagonists such as warfarin. We advise caution in the use of NOAC in patients with stroke or cerebral hemorrhage because of the following reasons:1) Patients with cerebral bleeding were excluded from the trials. 2) Stroke within 14days and severe stroke within 6months before screening were exclusion crite...
Source: Journal of the Neurological Sciences - April 29, 2013 Category: Neurology Authors: Claudia Stöllberger, Josef Finsterer Tags: Opinion Source Type: research