Drug requiring reduced monitoring may benefit Patients with Irregular Heartbeats

UK single-handedly accounts for 800,000 people who struggle with irregular heartbeats. This condition is more prevalent in older people leading to a significant rise in stroke risk and formation of blood clots. Any drug necessitating reduced monitoring compared to current standard treatment can prove beneficial in people ailing with this condition.
In the global study published in the New England Journal of Medicine and conducted by the University of Edinburgh and the Duke University in North Carolina, America, researchers evaluated the effects of the standard drug, warfarin, used to limit clotting in people with irregular heartbeats and compared it with a drug called rivaroxaban.

The stroke risk in patients with irregular heartbeats is four to six times higher. According to the study findings, both drugs were equally effective in reducing blood clotting and thereby decreasing stroke risk. However, reduced blood clotting can raise the risk of bleeding. Medications and diet have an effect on warfarin and therefore, patients consuming warfarin must be closely monitored to ascertain that the exact dose is administered. Comparatively, rivaroxaban does not necessitate dose adjustment and close monitoring.

Nearly 14,000 atrial fibrillation patients (high stroke risk) with irregular heartbeats who were administered either warfarin or rivaroxaban were evaluated by investigators. Although atrial fibrillation targets around 10% of above-65 year olds and is more frequent with age, it can affect adults of any age. While the study findings demonstrated a similar bleeding incidence with both drugs, the risk of fatal brain bleeding was reduced to only 50% (from 5 per thousand to approx. 2 per thousand) among those taking rivaroxaban.

Professor Keith Fox from the University of Edinburgh, supported by the British Heat Foundation, remarked on the study, “We know that about a third of patients eligible for warfarin are not currently receiving it. This may be because they are too frail and may not be able to manage taking the drug appropriately, with the need for blood tests and dosage levels to be monitored closely. This study shows that an alternative drug for patients with irregular heartbeats is just as effective while also easier to prescribe and take.”

Assistant Professor of Medicine at Duke University School of Medicine, Manesh R. Patel, MD, added, Warfarin has been a standard treatment for decades, but requires a rigorous monitoring schedule to ensure therapeutic dosing levels, and is subject to the potential of food and drug interactions that present treatment obstacles for patients and doctors alike. The results of this large global trial have convincingly shown rivaroxaban to be an alternative to warfarin in treating patients with atrial fibrillation and, importantly, with no increase in bleeding.”