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Hassle-free stroke prevention offered by new drug, Stanford researcher says

STANFORD, Calif. People who take a commonly prescribed yet problematic drug called Coumadin to prevent stroke or blood clots may soon have a hassle-free alternative, according to research at Stanford University School of Medicine. Results from a 7,329-person international study have found that a new drug called ximelegatran prevents strokes as effectively as Coumadin without the side effects or inconvenience.

"We think this will result in a huge shift in anti-coagulation therapy," said Gregory Albers, MD, professor of neurology and neurological sciences and director of the Stanford Stroke Center. Albers was a member of the steering committee that designed and directed the trial. Results from the 3,407-person international phase of the study will be published in the Nov. 22 issue of The Lancet. Albers and his colleagues presented results from the 3,922-person North American study at the American Heart Association meeting Nov. 11 in Orlando.

Coumadin effectively thins the blood and prevents strokes in people with a type of erratic heartbeat called atrial fibrillation. The problem is that the drug has a very narrow effective dose range too little and it doesn't work, too much and a person bleeds excessively. The drug also interacts with other medications and with food. Because of these complications, people on Coumadin must have their blood checked and dose adjusted regularly to make sure they are protected from stroke.

"Coumadin is very effective, but more than half of the people who should be receiving it don't take the medication because of the inconvenience," Albers said.

In contrast, ximelegatran is just as effective as Coumadin but doesn't require blood tests for dose adjustment and doesn't interact with medications or food. "It's essentially one-dose-fits-all," Albers said.

Called the Stroke Prevention Using an Oral Thrombin Inhibitor in Atrial Fibrillation, or SPORTIF, the studies comparing ximelegatran to Coumadin t
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Contact: Amy Adams
amyadams@stanford.edu
650-723-3900
Stanford University Medical Center
20-Nov-2003


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