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Dabigatran Use Highest Among Elderly — Physician’s First Watch

Medical News |
October 17, 2013

Dabigatran Use Highest Among Elderly

By Kelly Young

Use of the oral anticoagulant dabigatran has dramatically risen since its approval for atrial fibrillation in 2010. As of 2012, it accounted for 17% of all oral anticoagulant prescriptions in Ontario, according to a study in CMAJ Open.

Patients aged 85 and older — a group at increased bleeding risk — had the highest rate of dabigatran prescriptions.

The analysts point out that in the RE-LY trial, whose patients averaged 71 years of age, dabigatran had a lower risk for major bleeding than warfarin; however, among patients aged 80 and older, the two agents had equivalent bleeding risks.

They write: "Because no effective reversal agent exists for dabigatran, this difference in safety outcomes between the overall RE-LY trial cohort and the subgroup experiencing the most rapid 'real-world' uptake may have an unexpected impact in clinical practice."

Reader Comments (2)

A.T, Pharm.D. Other Healthcare Professional, Pharmacology/Pharmacy

As a direct thrmobin inhibitor, a class which it shares with likes of Argatroban, one wonders if measuring aPTT as an inpatient setting would be appropriate to monitor Dabigatran therapy. This is in light to the fact that there's no effective reversal agent if and when overdose is to occur.
This is a question I often encounter from nurses who work in cardiac unit where the use of dabigatran has increased significantly in recent months.

Dave rainham

Meaning that warfarin has a quick reversal method?
Even iv vit K takes a long time and jhow quick can you get that in a nursing home?

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