Oral Alternative to Warfarin for Venous Thromboembolism?

Dabigatran is a direct oral thrombin inhibitor that, unlike warfarin, can be given in a fixed dose and requires no laboratory monitoring. In a recently published study, dabigatran compared favorably with warfarin in patients with atrial fibrillation (JW Cardiol Sep 1 2009).

In this new industry-sponsored double-blind trial, more than 2500 patients with acute venous thromboembolism (69% with deep venous thrombosis [DVT] only, 21% with pulmonary embolism only, and 10% with both) were randomized to receive either warfarin or dabigatran after initial heparin therapy. At 6 months, no significant differences were found between the dabigatran and warfarin groups in incidence of recurrent venous thromboembolism (2.4% and 2.1%) or major bleeding (1.6…