Good news. Another one of the new oral anticoagulants in development, Apixaban (Eliquis®), has moved forward. On May 20th, 2011, the European Medicines Agency (EMA) approved Eliquis® for DVT prevention after orthopedic surgery (hip and knee replacement) in the 27 countries of the European Community. In the U.S., however, Eliquis® is still some way away from getting FDA approval and coming onto the market.
Eliquis® is an anticoagulant, a factor Xa inhibitor, that has the same advantages as the other new oral anticoagulants, such as Pradaxa® (Dabigatran) and Xarelto® (Rivaroxaban): (a) no need for monitoring of its anticoagulant effect (i.e. no need to determine INRs), (b) no influence of vitamin K in the diet on anticoagulant effect, (c) active within a few hours of being taken as a tablet, and (c) out of the system within approximately 1 1/2 days after stopping it, so easier to manage at time of surgeries and procedures, such as colonoscopies.
As for DVT and PE treatment: two large phase 3 clinical studies with Apixaban are still ongoing : (a) a treatment trial of Apixaban versus Warfarin for 6 months in symptomatic DVT and PE, and (b) an extended VTE treatment trial comparing Apixaban to placebo [www.clinicaltrials.gov].
Addendum: On Aug 28th, 2011, the large atrial fibrillation trial comparing Apixaban with warfarin was published in the NEJM. A new blog entry discussing this trial can be found here.
Disclosure: I have no financial disclosures relevant to the content of this blog post.
Last updated: Aug 28th, 2011
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