Blood-thinning drug could transform stroke treatment

A new blood-thinning drug could end the use of rat poison as a primary medical treatment to prevent stroke, it was claimed today.

For half a century, thousands of patients at risk of stroke have been given warfarin to prevent blood clotting. But treatment with the drug, commonly used to kill vermin, is risky.

Doses have to be carefully watched and adjusted to prevent excessive bleeding from cuts or stomach ulcers, requiring frequent clinic visits. Warfarin can also interact badly with other drugs and certain foods.

The new drug, Pradaxa, works in a different way and is far safer. Patients taking the pill twice a day do not have to be constantly checked for signs of overdosing, and can eat what they like.

Results from a major trial showed that Pradaxa was 34 per cent better at reducing the risk of stroke and blood clots in at-risk patients than well-controlled warfarin. More than 18,000 patients from 44 countries took part in the three-year RE-LY (randomised evaluation of long term anticoagulant therapy) trial, the largest of its kind ever conducted.

Participants had an average age of 71 and all suffered from atrial fibrillation, a heart rhythm disorder that greatly increases the risk of stroke. They were randomly assigned to treatment either with Pradaxa or warfarin.

The findings were published online in the New England Journal of Medicine.

Professor Stuart Connolly, one of the leading investigators from McMaster University in Hamilton, Canada, said: "We now have an oral treatment which offers superior protection from stroke with less bleeding and without the need for routine monitoring."

At present the drug is only licensed in the UK for the treatment of orthopaedic patients at risk of clotting after surgery. An application for permission to use it for the prevention of stroke is pending.