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Edoxaban pivotal trial shows VTE efficacy, safety (copy 1)

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Edoxaban safe, effective for PE

Dr. Steven Q. Simpson

Dr. Steven Q. Simpson, FCCP, comments: This study is relevant, because investigators treated VTE patients in a standard fashion, but randomized to Factor Xa inhibition vs. warfarin.It is important that this strategy provides equivalent inhibition of recurrent clot, with a safety profile that is better. However, it is a very interesting finding that patients with evidence of right ventricular dysfunction actually had better outcomes on the new regimen than on warfarin.
We may now have entered the era where we can liberate our patients from the periodic blood draws, concerns about diet and concomitant medications, and much of the bleeding risk associated with warfarin therapy.Warfarin has saved many lives in its career, but it is time to consider retiring.


 

AT ESC 2013

The data collected on all three oral factor X inhibitors so far suggest that they all are "noninferior to standard treatment and are also not inferior and most likely superior for safety, with apixaban showing the best safety profile so far," said Dr. Konstantinides, who was the designated discussant for Dr. Büller’s report. But Dr. Konstantinides also warned that these new drugs will need to "justify their high cost" by showing improvements in patient satisfaction with their treatment and quality of life, and by lowering overall health-care costs by lowering the number of rehospitalizations in VTE patients.

Hokusai-VTE was sponsored by Daiichi-Sankyo, the company developing endoxaban. Dr. Büller said that he has received honoraria from Daiichi Sankyo, as well as from Bayer, Boehringer Ingelheim, Pfizer/Bristol-Myers Squibb, Isis, and Thrombogenics. Dr. Büller also served as a principal investigator for the VTE pivotal trials of rivaroxaban and apixaban. Dr. Zoghbi said that he had no relevant disclosures. Dr. Konstantinides has been a speaker for and an advisor to Boehringer Ingelheim, Bayer, and Pfizer/Bristol-Myers Squibb.

mzoler@frontlinemedcom.com

Twitter:@mitchelzoler

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