A new oral blood thinner is being compared to an old standby to see if it works as well and is easier to manage long term, researchers say.

Other medications and even diet can dramatically impact blood levels of warfarin, or Coumadin, increasing the risk of bleeding or clotting, says Dr. James R. Gossage Jr., pulmonologist at the Medical College of Georgia.

"You eat too much broccoli or spinach and it sends your levels out of whack; almost every other medicine affects Coumadin," says Dr. Gossage, who calls warfarin a "high-maintenance" medication.

Unfortunately, many people, including those with a clot in their legs called deep vein thrombosis or their lungs called pulmonary embolism may need it for months or years, Dr. Gossage says.

An international study of 2,000 adult patients with these problems will determine if dabigatran, manufactured by Boehringer Ingelheim, a Germany based pharmaceutical company, makes long-term clot control easier.

Deep vein thrombosis or a pulmonary embolism generally are treated with intravenous blood thinners; really big clots also may need a clot-buster like tPA, says Dr. Gossage, a principal investigator on the study. Blood thinners keep the clot from growing while the body's endogenous clot-busters eliminate it. That can take a while, especially when clots measure several inches or more, so patients also need a blood thinner they can take at home for months or longer, depending on their diagnosis. When patients start taking warfarin, they need daily, then weekly monitoring until levels stabilize, then at least monthly checks as long as they take the drug, he says.

At the right level, the drug works well, inhibiting vitamin K, which is involved in the synthesis of several coagulation factors and found in abundance in green leafy vegetables, vegetable oils, cranberries and even licorice. "It's very uncommon for a person taking warfarin to have a blood c
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Contact: Toni Baker
tbaker@mcg.edu
706-721-4421
Medical College of Georgia
12-Feb-2007