Replacement Drug for Warafin Coming Soon?

[Rush20]

I read an article in the Chicago Tribune today about an upcoming drug that may replace Coumadin/Warafin.

The drug is called Ximelagatran and will be marketed under the name "Exantra". Derived from amino acids, it inhibits the action of thrombin, a constituent of the blood that affects clotting. A considerable amount of research has shown that Exantra is at least as effective, possibly more so, as Warafin.

Unlike Warafin, this drug uses a fixed dose without having to monitor coagulation. When Exantra becomes available in the near future, you won't need to check your blood while taking it. It is not effected by food or other medication; and although it leaves you vulnerable to bleeding (after all, it is a anticoagulant), it is safe.

The article goes on to point out that its introduction will emanicate most, if not all, users of Warafin.

Pretty bold prediction and I'm wondering if anyone else has heard of this drug. My next Cardio appointment is mid-March and I plan to ask my doctor.

 

[LUVMyBirman]

Hi Allen,

Yes, you should find many threads of discussion if you do a search right here on VR.com.

Personally, my carido stated he may have trouble recruting patients for his "study" if Exantra is approved for trial in valve patients.

In a roundabout way...he asked my opinion. I am not interested in any such trial. Kudos to the drug manufacturer if this all works out. If approved my plan is to sit back and evaluate for 4 years before even considering it. One of the drawbacks is in that the long term effects on the liver are unknown.

Noticed you are in the Chicago area. We are meeting next month if you are interested.

 

[Rush20]

Thanks Gina. After posting, I realized that there were existing thread. Oh well, sometimes I get excited and don't perform the proper research....

Regarding the Chicago event, sounds great. I'll look for the thread.

 

[Ross]

Sometimes you can perform all the proper research and still not get an answer.

The way it stands now, Don't bet the farm on it! It's not even being discussed currently.

 

[Guest]

Here is what Exanta vs warfarin boils down to:
Exanta has no need for monitoring - warfarin does.
Exanta causes bleeding - maybe more than warfarin - at least the published studies show more than in my clinic.
Exanta may cause liver damage - warfarin has not in almost 50 years on the market.
There are no reports on Exanta being taken longer than an average of about 18 months - one member of this site started it 43 years ago.
Nobody has reported a study that showed Exanta solved any clotting or bleeding problems that anyone was having with warfarin.
Exanta does not require monitoring but many studies have shown that people who take a drug that has no obvious effect stop taking it. If this happens with Exanta, then you will wreck your valve or have a stroke.
As far as I can determine, Exanta is not being studied in people with mechanical heart valves.
I think that doctors considering putting people on Exanta need to discuss these things with the people.

The AstraZeneca marketing department is putting out a lot of press releases about saving people from warfarin but it may be a case of out of the frying pan and into the fire.

 

[Rich]

I'm with Gina on this one.
I won't bet my life on something that new.
Coumadin may be a pain sometime but it has a lot of history to back it up.

 

[Guest]

Probably the wierdest thing of all is that it does not cut down on bleeding. If it did that, then some people would be willing to risk the liver stuff.

 

[Valve-Viking]

If nobody never dared to do any trials, how would a new
medicine ever develope? I know some people that have been
on the exanta-trials and I think one should be very grateful
that some are willing to take the risk! But of course it is up
each and everyone to make their own decision and I have
to admit I´d be scared to be on an exanta-trial for valves as example. But I would consider it hard.

Other positive aspects with Exanta is that it doesn´t
interact with food, other medicines, etc and the chance of
having an unforseen bleeding is therefore much less - I
mean why do we all go and check our INR´s so often?

I have a friend that would very much need some other
medicines, but he simply can´t take it due to the intercation
with Warfarin. This won´t kill him, but it greatly reduces his
quality of life.

It is also many people that should do well with warfarin that
refuses to take it due to all the tests regulary needed. Every-
body here knows testing is o.k and just a new routine to
get used to, like doin´your washes, mowing your lawn etc,
but fact is, it stops many from taking the medicine they would
very much need. So if exanta worked, this would save a lot
of more lifes indirectly.

So let´s see how it goes and let´s hope it will be a great
success, but look at this with facts and objectivity during
all circumstances. Developing a new medicine could be like
running a marathon and stumble just before the finishing line when you are already being cheered by the masses! Let´s
be objective, but positive!

 

[catwoman]

Al:

Would Exanta be tested first on animals (for use with mechanical valves)? I've read some on OHS history and valve surgery, and mechanical valves were first tested in canines.
Don't know if physiological, biochemical, etc., differences would preclude this.

 

[Guest]

Valve-Viking,
One of the big problems with Exanta is that it causes at least as much bleeding as warfarin. Just because you don't monitor it doesn't mean that it doesn't cause bleeding. The published results with Exanta show that people have bleeding about twice as often as they do at my clinic.

There are no other medications that cannot be used with warfarin. Many doctors think that just because something interacts that it cannot be used. This just isn't true. I have been managing warfarin for almost 7 years (full-time) and I wish I knew how many times doctors called and asked about this. All you have to do is to raise or lower then warfarin dose a little. The only difference in the quality of life is that they have to come in for about 2 extra 20-minute visits so I can adjust the warfarin dose. I agree that this will be easier with Exanta but it has not been a problem.

My guess is that the people who are afraid of warfarin because they have to get tested is that once they find out that Exanta cannot be controlled by testing and that it causes just as many problems - they will be just as afraid of it. We will have to wait and see.

Did your frends know if they were taking warfarin or Exanta. So far all of the published studies have been about people who did not know which one they were getting. They even altered the testers to give phony results to the people on Exanta so that they would not know.

I'm willing to wait and see. I just do not agree with all of the media hype about how this is going to be such a great drug. There is no evidence for that in any published article yet.

Cat...
One of the officials of AstraZeneca told me in October 2002 that they were testing Exanta on sheep. They put a mechanical valve in the aorta and routed all of the blood through the kidney. That way they would only have to examine the kidney for clots. So far I have not seen any published results of that study. They also have no mention of any use for people with valves mentioned on their websites. They may be not telling because of trying to keep the competition in the dark but they have been pretty open about the other things.