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Drug: Pradaxa
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Blaming Obamacare is the wrong diagnosis
The Wall Street Journal began the week by publishing a provocative essay in which a young man suggested Obamacare kept his mother from getting appropriate medicine for her cancer. The writer crafted a poignant story about his mother, who sounds like a good person with a bad disease.
Mainstream media buzzes with these types of stories. The Obamacare-is-the-problem narrative fits quite well on conservative news outlets.
The problem, as it so often is, is in the details.
The story here begins with a familiar first chapter: the writer’s mother had good insurance coverage but then it was cancelled. Next came her struggle...
Source: Dr John M - February 25, 2014 Category: Cardiology Authors: Dr John Source Type: blogs
New post up at Medscape Cardiology: Are novel anticoagulants better than warfarin?
For the prevention of stroke in atrial fibrillation, the novel anticoagulant drugs dabigatran (Pradaxa, Boehringer Ingelheim), rivaroxaban (Xarelto, Bayer Pharma/Janssen Pharmaceuticals), apixaban (Eliquis, Pfizer/Bristol-Myers Squibb), and edoxaban (Lixiana, Daiichi-Sankyo) have been sold as both superior and more convenient than warfarin.
But is this true? More than 60,000 patients have been enrolled in randomized controlled clinical trials. Recently, two meta-analyses (studies that combine trials) have been published. That’s a bunch of data.
I had originally set out to explain how these meta-analyses had once and ...
Source: Dr John M - December 20, 2013 Category: Cardiology Authors: Dr John Source Type: blogs
Are doctors being duped through medical education? Could social media help?
I made a discovery this week about the novel anticoagulant medications, dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Lixiana). I was looking into the often-asked question of how these new drugs compare to the old standard, warfarin.
The discovery felt like a Eureka moment. I ran it by my stats guy–my son–and a couple of colleagues, and they confirmed, that my discovery was truth. I’m working on a post now that discusses the details of how the medical world has been misled about these drugs. Stay tuned.
Medical Education:
For now, though, this revelation got me thinking abo...
Source: Dr John M - December 14, 2013 Category: Cardiology Authors: Dr John Source Type: blogs
Recap of 2013 American Heart Association Session
Just a few weeks before the 2013 American Heart Association Sessions, Shelley Wood, the managing news editor of theheart.org emailed to ask if I was up for going to the meeting. With trips to San Francisco, Denver, Athens and Amsterdam already in the books this year, I had counted 2013 as a win. I was ready to ease into Thanksgiving and conclude the bike season with a couple of cold-weather CX races. But when opportunity presents itself, ie,,,when the big strong guy in front of you attacks, it makes sense to follow.
Yes. Yes. I am in. I was excited to see my THO friends again. I was excited to write and learn.
My role at m...
Source: Dr John M - November 24, 2013 Category: Cardiology Authors: Dr John Source Type: blogs
Disappointing Results with Dabigatran for Mechanical Valves
Despite being more durable than bioprosthetic valves, mechanical heart valves are often not chosen because of the requirement for lifelong anticoagulant therapy. It has been hoped that the newer generation of oral anticoagulants might eventually replace warfarin, making anticoagulation more tolerable and better accepted, since these agents don’t require continuous monitoring and have much fewer serious interactions with other drugs and food. So far, however, there has been no convincing demonstration that the the newer agents are as safe and effective as warfarin for this indication. RE-ALIGN was a phase 2 dose-valid...
Source: CardioBrief - September 1, 2013 Category: Cardiology Authors: Larry Husten Tags: Uncategorized Anticoagulant Artificial heart valve dabigatran European Society of Cardiology new england journal of medicine RE-ALIGN warfarin Source Type: blogs
A statistical joke called “Non-Inferiority” drug trial !
Of late many drugs are entering the market for human consumption backed up by Non -Inferiority trials (NIT ) .Few examples.
“The ONTARGET trial: Telmisartan is non-inferior to Ramipril in New Study Results Published in the New England …”
“Feb 20, 2013 – … in the New England Journal of Medicine Show Dabigatran Etexilate ... daily was non-inferior to warfarin (p=0.01) in preventing recurrent VTE, …”
What is the logic behind these Non inferiority trials ?
Why it came into vogue ?
Do you agree with the concept of NIT ?
Take Our Poll
I have taken the privilege...
Source: Dr.S.Venkatesan MD - August 27, 2013 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology-Statistics Uncategorized gimmicks in medical statistics non inferiority clinical trials Non inferiority drug trials Source Type: blogs
The COURAGE patients who crossed over; two new analyses link dabigatran to MI risk; beta-blockers in HF get bum rap for most "side effects"; 10 emerging uses for cardiac CT
Source: Blogs@theHeart.org - July 19, 2013 Category: Cardiology Authors: theheart.org Tags: This week in cardiology from heartwire Source Type: blogs
Physician Payment Sunshine: ProPublica Matches Medicare Part D Data with Physician Manufacturer Payment Data in an Attempt to Discredit Physicians
With less than a month to go before applicable manufacturers must begin reporting payments to physicians and teaching hospitals as required by the Physician Payments Sunshine Act, ProPublica last week launched another series of articles using its Dollars for Docs website and its new Prescriber Checkup database of Medicare Part D claims to publish two stories about improper payments or relationships.
As a reminder to all physicians, Ardis Hoven, MD, president of the American Medical Association (AMA), recently noted that the association had made efforts to ensure that physicians would be able to challenge inaccurate or ...
Source: Policy and Medicine - July 3, 2013 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs
Renal denervation; saturated fat; heparin vs bivalirudin; dabigatran "real-life"
Renal denervation; saturated fat; heparin vs bivalirudin; dabigatran real-life
Source: Blogs@theHeart.org - May 24, 2013 Category: Cardiology Authors: theheart.org Tags: This week in cardiology from heartwire Source Type: blogs
Registry Study Offers Reassurance About Safety And Efficacy Of Dabigatran
As the first new oral anticoagulant since warfarin, dabigatran (Pradaxa, Boehringer-Ingelheim) has been subject to intense concerns over its safety and efficacy in a real-world population. Last November an FDA investigation found no indication that bleeding rates for dabigatran were any higher than bleeding rates for warfarin. A new study from Scandinavia, published in the Journal of the American College of Cardiology (see note at bottom of story), provides more real-world information that helps to confirm the safety and efficacy of the new drug. Using data from the Danish Registry of Medicinal Product Statistics, re...
Source: CardioBrief - April 4, 2013 Category: Cardiology Authors: Larry Husten Tags: Heart Rhythms Prevention, Epidemiology & Outcomes anticoagulants boehringer ingelheim dabigatran Pradaxa warfarin Source Type: blogs
#183: Mixed messages on new bleeding data with dabigatran; "high-potency" statins linked to acute kidney injury; dabigatran might cut hospital days vs standard anticoagulants in new AF; US supermarket chain giving away atorvastatin
Mixed messages on new bleeding data with dabigatran; "high-potency" statins linked to acute kidney injury; dabigatran might cut hospital days vs standard anticoagulants in new AF; US supermarket chain giving away atorvastatin
Source: Blogs@theHeart.org - March 22, 2013 Category: Cardiology Authors: theheart.org Tags: This week in cardiology from heartwire Source Type: blogs
