BARNES, HEDWARD 06:38
MR 20/08/1940 Male 654321 Emergency Care Centre
Specimen No : AK564330X Haematology & Chemistry
03/04/2015 06:38 Citrated Blood
Request Reason : chest pain
PT 20.4 s ( 12 to 16 ) Auth
APTT 51.3 s ( 22.0 to 35 ) Auth
APTT Ratio ^1.8 Auth
I.N.R. 1.4 Auth
LTG Comments :
Patient is on dabigatran
3 April 2015 (Friday) - Dabigatran
Dabigatran (Pradaxa or Prazaxa) is an oral anticoagulant acting as a direct thrombin inhibitor. It is being trialled for various clinical indications and is claimed to offer an alternative to warfarin as the preferred orally administered anticoagulant since it does not require INR monitoring while offering similar results in terms of efficacy.
There is no specific way to reverse the anticoagulant effect of dabigatran in the event of a major bleeding event unlike warfarin although a potential dabigatran antidote (pINN: idarucizumab) is undergoing clinical studies.
It was developed by the pharmaceutical company Boehringer Ingelheim… on July 26, 2014, the British Medical Journal (BMJ) published a series of investigations that accused Boehringer of withholding critical information about the need for monitoring to protect patients from severe bleeding, particularly in the elderly.
Reviews of internal communications between Boehringer researchers and employees, the FDA and the EMA revealed that Boehringer researchers found evidence that serum levels of dabigatran vary widely. The BMJ investigation suggested that Boehringer had a financial motive to withhold this concern from regulatory health agencies because the data conflicted with their extensive marketing of dabigatran as an anticoagulant that does not require monitoring.
I can’t help but wonder how many other “wonder drugs” aren’t quite so wonderful. Perhaps if they weren’t quite so lucrative…?