From the Wires
New Sub-Analyses Report Pradaxa® (dabigatran etexilate mesylate) May Be Associated With Better Patient Outcomes After a Major Bleeding Event Compared to Warfarin
Data Presented at American Society of Hematology (ASH) Annual Meeting and Highlighted as "Best of ASH"
By: PR Newswire
Dec. 8, 2012 12:00 PM
RIDGEFIELD, Conn., Dec. 8, 2012 /PRNewswire/ -- Boehringer Ingelheim Pharmaceuticals, Inc. today announced results from two new post-hoc sub-analyses comparing the clinical management and outcomes of patients who experienced major bleeding while treated with dabigatran or warfarin. These findings from the RE-LY® trial and four other Phase III trials report outcomes after a major bleed on dabigatran, despite the lack of a specific reversal agent, may be better than after a warfarin-associated bleed. The sub-analyses also indicate that the overall medical resources used to manage bleeding were not greater with dabigatran. These data were presented today at the 54th Annual Meeting of the American Society of Hematology in Atlanta, Ga.
"Bleeding, especially major bleeding, is a well-recognized concern with all blood thinners. The sub-analyses report that major bleeding outcomes with dabigatran, using standard clinical support measures, appeared to be better than warfarin and required no greater use of medical resources," said Sam Schulman, M.D., Ph.D., FRCPC(C), professor, Department of Medicine, McMaster University, Ontario, Canada.
The data consist of two retrospective sub-analyses that reviewed the use of resources and hospital length of stay after major bleeds in patients treated with dabigatran or warfarin.
In the sub-analysis of the RE-LY study alone, the rate of major bleeds requiring surgery was lower for patients on dabigatran than warfarin (12.1 percent and 15 percent, respectively). While dabigatran and warfarin patients were hospitalized at the same rates and length of stay was the same, time spent in the intensive care unit (ICU) and coronary care unit (CCU) was less for patients on dabigatran than on warfarin (1.6 nights and 2.7 nights, respectively).
Management of bleeding events for dabigatran or warfarin was based on current standards of clinical care, including: blood transfusion, fresh frozen plasma, vitamin K, prothrombin complex concentrate and recombinant factor VIIa. In the RE-LY sub-analysis alone, patients on dabigatran were more frequently treated with blood transfusions than those on warfarin (59.2 percent and 49.9 percent, respectively). Patients on dabigatran were less frequently treated with fresh frozen plasma than those on warfarin (19.8 percent and 30.2 percent, respectively).
More patients in the dabigatran group were older than the warfarin group (mean age of 75.3 and 71.8, respectively), had lower median creatinine clearance (53 mL/min and 62 mL/min, respectively) and were using aspirin (30.9 percent and 24.6 percent, respectively) or non-steroidal anti-inflammatory drugs (NSAIDs) (12.9 percent and 8.4 percent, respectively).
The RE-LY trial utilized the established PROBE (prospective, randomized, open-label, blinded endpoint evaluation) clinical trial protocol, which has been used in the previous trials of anticoagulation for stroke prevention in patients with AFib. A PROBE design may reflect the differences in the management of warfarin and dabigatran in clinical practice.
The primary endpoint of the trial was incidence of stroke (including ischemic and hemorrhagic) and systemic embolism. The primary safety endpoint was major bleeding, defined as a reduction in the hemoglobin level of at least 2.0 g/dL, transfusion of at least two units of blood, or symptomatic bleeding in a critical area or organ. Other safety endpoints included bleeding events (major and minor), intracerebral hemorrhage, other intracranial hemorrhage, elevations in liver transaminases, bilirubin and hepatic dysfunction and other adverse events.
In the RE-LY trial, all clinical outcomes were adjudicated in a blinded manner to assess outcomes for each treatment.
*Although studied in the RE-LY trial, dabigatran 110mg is not approved by the U.S. FDA.
About Pradaxa® (dabigatran etexilate mesylate) Capsules
Indications and Usage
IMPORTANT SAFETY INFORMATION ABOUT PRADAXA
WARNINGS & PRECAUTIONS
Temporary Discontinuation of PRADAXA
Effect of P-gp Inducers & Inhibitors on Dabigatran Exposure
Patients with Prosthetic Heart Valves
Other Measures Evaluated
For full PRADAXA prescribing information, please visit www.pradaxa.com or contact Boehringer Ingelheim's Medical and Technical Information Unit at 1-800-542-6257.
About the Boehringer Ingelheim Cares Foundation Patient Assistance Programs
About Boehringer Ingelheim Pharmaceuticals, Inc.
The Boehringer Ingelheim group is one of the world's 20 leading pharmaceutical companies. Headquartered in Ingelheim, Germany, it operates globally with 145 affiliates and more than 44,000 employees. Since it was founded in 1885, the family-owned company has been committed to researching, developing, manufacturing and marketing novel medications of high therapeutic value for human and veterinary medicine.
As a central element of its culture, Boehringer Ingelheim pledges to act socially responsible. Involvement in social projects, caring for employees and their families, and providing equal opportunities for all employees form the foundation of the global operations. Mutual cooperation and respect, as well as environmental protection and sustainability are intrinsic factors in all of Boehringer Ingelheim's endeavors.
In 2011, Boehringer Ingelheim achieved net sales of about $17.1 billion (13.2 billion euro). R&D expenditure in the business area Prescription Medicines corresponds to 23.5% of its net sales.
PRADAXA® is a registered trademark of Boehringer Ingelheim Pharma GmbH and Co. KG and used under license.
RE-LY® is a registered service mark of Boehringer Ingelheim International GmbH and used under license.
SOURCE Boehringer Ingelheim Pharmaceuticals, Inc.
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