Pradaxa vs. Warfarin: Should Cardiac Patients Worry?

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Recent news about the possibility that the relatively new blood clot preventing drug Pradaxa has been associated with an in increase in heart attacks can lead to confusion for cardiac patients over whether they should be concerned that their doctor is prescribing Pradaxa over its time-tested competitor Warfarin. In some ways comparing Pradaxa vs. Warfarin is like comparing health news sites—some have slightly more or different benefits than others. Presented here is a synopsis of Pradaxa vs. Warfarin views and a link to a cardiac specific article that presents a more detailed discussion that provides cardiac patients a clearer understanding of whether they should worry about whether they are taking Pradaxa over Warfarin.

One way to look at the Pradaxa vs. Warfarin news is that it is partly about the Latin phrase “primum non nocere.” “Primum non nocere” is just one of several fundamental medical ethics originating from the Hippocratic Oath that plays an important role toward providing healthcare that is both safe and beneficial to patients. It is more commonly known by its “First, do no harm” interpretation that comes from a rough Greek translation of “I will prescribe regimens for the good of my patients according to my ability and my judgment, and never do harm to anyone.”

Another way to look at the Pradaxa vs. Warfarin news is that it is also partly about the history of the drug Warfarin. Warfarin has been used successfully for several decades as a blood thinning medication important to patients with cardiac problems and other medical conditions where the threat of a life-ending blood clot exits. Some will argue that it is safer to stick with a medication that you know works, even though it may not work perfectly all the time. Warfarin for example, is known for presenting side effects like uncontrolled bleeding.

Pradaxa, on the other hand, is a new kid on the block blood thinning agent that shows promise as a potential replacement for Warfarin. Its history, however, is thus far very recent and health officials are cautious about whether it is truly a better choice over Warfarin. News reports of seemingly conflicting studies were published recently stating that Pradaxa both, may or may not be linked to an increase in heart attacks in comparison to Warfarin and other blood thinning drugs.

In a nutshell, both studies looked at Pradaxa from different viewpoints both data-wise and underlying cardiac condition-wise. It’s kind of like doing a taste test comparing apples and oranges and asking if one is sweeter than the other—it depends on the parameters of what is measured and what you mean by “sweeter.”

A third way to look at the Pradaxa vs. Warfarin news is that it is also partly about the money: Whichever blood thinning drug “wins” as the better of the two, will result in earnings for its maker, shareholders, sales reps, etc. And of course, this is cause for justified concern. Pradaxa is not the first drug heavily marketed to consumers as a drug of choice, nor will it be the last. Another Latin phrase “caveat emptor” - buyer beware, is warranted here as well.

Fortunately, a cardiac-specific and WEBMD owned theheart.org has recently published an online study that indirectly addresses the aforementioned views and provides for the reader a more comprehensive take on the two studies that appear at odds with each other over the Pradaxa vs. Warfarin question. In it, the cardiac patient reader will find some reassurance that the authors from both studies do not see each other’s results in conflict, and agree that further study is needed to determine which drug is the better and under what condition parameters.

Right now it looks like it’s a tie.

Image credit: Courtesy of Wikipedia

Source: The Heart.org— Dabigatran: New data on MI and ischemic events

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