Dabigatran: Difference between revisions
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In [[medicine]], '''dabigatran''' is an [[anticoagulant]] that is a direct [[thrombin]] inhibitor<ref>{{MeSH}}</ref> | In [[medicine]], '''dabigatran''' is an [[anticoagulant]] that is a direct [[thrombin]] inhibitor<ref>{{MeSH}}</ref> Unlike [[warfarin]], is dabigatran is administered in fixed doses without the need for coagulation monitoring. | ||
==Pharmacology== | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id= | ===Absorption=== | ||
Dabigatran reaches peak plasma concentrations within 0.5-2 hours.<ref name="pmid18956996">{{cite journal| author=Baetz BE, Spinler SA| title=Dabigatran etexilate: an oral direct thrombin inhibitor for prophylaxis and treatment of thromboembolic diseases. | journal=Pharmacotherapy | year= 2008 | volume= 28 | issue= 11 | pages= 1354-73 | pmid=18956996 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=18956996 | doi=10.1592/phco.28.11.1354 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
===Distribution=== | |||
===Metabolism=== | |||
===Excretion=== | |||
Dabigatran is renally excreted. | |||
===Toxicity=== | |||
[[Drug toxicity]] includes elevation in [[liver function test]]s.<ref name="pmid18956996">{{cite journal| author=Baetz BE, Spinler SA| title=Dabigatran etexilate: an oral direct thrombin inhibitor for prophylaxis and treatment of thromboembolic diseases. | journal=Pharmacotherapy | year= 2008 | volume= 28 | issue= 11 | pages= 1354-73 | pmid=18956996 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=18956996 | doi=10.1592/phco.28.11.1354 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
==Clinical uses== | |||
===Atrial fibrillation=== | |||
{| class="wikitable" align="right" | {| class="wikitable" align="right" | ||
|+ [[Dabigatran]] versus [[warfarin]] for [[atrial fibrillation]]<ref name="pmid19717844">{{cite journal| author=Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A et al.| title=Dabigatran versus Warfarin in Patients with Atrial Fibrillation. | journal=N Engl J Med | year= 2009 | volume= 361 | issue= 12 | pages= 1139-1151 | pmid=19717844 | |+ [[Dabigatran]] versus [[warfarin]] for [[atrial fibrillation]]<ref name="pmid19717844">{{cite journal| author=Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A et al.| title=Dabigatran versus Warfarin in Patients with Atrial Fibrillation. | journal=N Engl J Med | year= 2009 | volume= 361 | issue= 12 | pages= 1139-1151 | pmid=19717844 | ||
| Line 20: | Line 35: | ||
|colspan="4"|† p < 0.05 as compared to warfarin group | |colspan="4"|† p < 0.05 as compared to warfarin group | ||
|} | |} | ||
In 2009, [[dabigatran]], a [[direct thrombin inhibitor]]s, was compared to [[warfarin]] in the RE-LY [[randomized controlled trial]] for the treatment of [[atrial fibrillation]].<ref name="pmid19717844">{{cite journal| author=Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A et al.| title=Dabigatran versus Warfarin in Patients with Atrial Fibrillation. | journal=N Engl J Med | year= 2009 | volume= 361 | issue= 12 | pages= 1139-1151 | pmid=19717844 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19717844 | doi=10.1056/NEJMoa0905561 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
===Deep venous thrombosis=== | |||
Dabigatran was as effective as [[warfarin]] for the treatment of deep venous thrombosis in the RE-COVER [[randomized controlled trial]].<ref>{{Cite journal | |||
| doi = 10.1056/NEJMoa0906598 | |||
| pages = NEJMoa0906598 | |||
| last = Schulman | |||
| first = Sam | |||
| coauthors = Clive Kearon, Ajay K. Kakkar, Patrick Mismetti, Sebastian Schellong, Henry Eriksson, David Baanstra, Janet Schnee, Samuel Z. Goldhaber, the RE-COVER Study Group | |||
| title = Dabigatran versus Warfarin in the Treatment of Acute Venous Thromboembolism | |||
| journal = N Engl J Med | |||
| accessdate = 2009-12-06 | |||
| date = 2009-12-06 | |||
| url = http://content.nejm.org/cgi/content/abstract/NEJMoa0906598v1 | |||
}}</ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 09:12, 6 December 2009
In medicine, dabigatran is an anticoagulant that is a direct thrombin inhibitor[1] Unlike warfarin, is dabigatran is administered in fixed doses without the need for coagulation monitoring.
Pharmacology
Absorption
Dabigatran reaches peak plasma concentrations within 0.5-2 hours.[2]
Distribution
Metabolism
Excretion
Dabigatran is renally excreted.
Toxicity
Drug toxicity includes elevation in liver function tests.[2]
Clinical uses
Atrial fibrillation
| Intervention | Outcomes | ||
|---|---|---|---|
| Stroke or systemic embolism | Major bleeding | Mortality | |
| Dabigatran 110 mg twice daily | 1.53% | 2.71%† | 3.75% |
| Dabigatran 150 mg twice daily | 1.11%† | 3.11% | 3.64% |
| Warfarin | 1.69% | 3.36% | 4.13% |
| † p < 0.05 as compared to warfarin group | |||
In 2009, dabigatran, a direct thrombin inhibitors, was compared to warfarin in the RE-LY randomized controlled trial for the treatment of atrial fibrillation.[3]
Deep venous thrombosis
Dabigatran was as effective as warfarin for the treatment of deep venous thrombosis in the RE-COVER randomized controlled trial.[4]
References
- ↑ Anonymous (2024), Dabigatran (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 Baetz BE, Spinler SA (2008). "Dabigatran etexilate: an oral direct thrombin inhibitor for prophylaxis and treatment of thromboembolic diseases.". Pharmacotherapy 28 (11): 1354-73. DOI:10.1592/phco.28.11.1354. PMID 18956996. Research Blogging.
- ↑ 3.0 3.1 Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A et al. (2009). "Dabigatran versus Warfarin in Patients with Atrial Fibrillation.". N Engl J Med 361 (12): 1139-1151. DOI:10.1056/NEJMoa0905561. PMID 19717844. Research Blogging.
- ↑ Schulman, Sam; Clive Kearon, Ajay K. Kakkar, Patrick Mismetti, Sebastian Schellong, Henry Eriksson, David Baanstra, Janet Schnee, Samuel Z. Goldhaber, the RE-COVER Study Group (2009-12-06). "Dabigatran versus Warfarin in the Treatment of Acute Venous Thromboembolism". N Engl J Med: NEJMoa0906598. DOI:10.1056/NEJMoa0906598. Retrieved on 2009-12-06. Research Blogging.