Most of us might recognize Xarelto from the commercial with Kevin Nealon and Arnold Palmer. Unless you or someone you know takes it, you probably don’t know that it causes some patients to bleed uncontrollably after trauma. Xarelto, a blood-thinner, was approved as a safer warfarin alternative for patients at high risk of a stroke months ago, but it still had its dangers. Now a new drug is up for approval.
Earlier this month, Portola Pharmaceuticals posted the application for the drug, andexanet alfa, which quickly reverses the anticoagulant effects of Xarelto and Eliquis. It’s expected to be approved and hit the market in 2016. This anti-coagulant antidote can prevent major bleeding episodes in patients taking those highly advertised medications.
According to Reuters, an emergency physician at Thomas Jefferson University Hospital, Dr. Charles Pollack said, “It may be uncommon, but they’re memorable when they happen … We didn’t have a specific reversal strategy for these drugs and I think that left people feeling a bit insecure.” It’s not hard to imagine such incidents must be terrifying for patients, and apparently for doctors too.
“I have many physicians, particularly surgeons, who hate these drugs,” Dr. Mariell Jessup, cardiologist at the University of Pennsylvania Medical Center explained. “They’re frightened of them because they’ve had to deal with the consequences of somebody coming in with trauma.”
Like warfarin, Xarelto and Eliquis are intended for patients suffering from atrial fibrillation, a type of irregular heartbeat that makes a person much more likely to have a stroke. Xarelto doesn’t place the same restrictions on the patient’s diet and may cause fewer major bleeding incidents compared to warfarin, but still reduces a person’s ability to form blood clots and therefore stop bleeding. Having an antidote like andexanet alfa puts patients and doctors at ease and decreases risk dramatically. Unfortunately, Portola’s first drug is not intended for use with warfarin, aka Coumadin, which still commands 60 percent of the anti-coagulant market.