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Edoxaban ‘as effective as warfarin’

Published on 02/09/13 at 02:32pm
Daiichi Sankyo image

Daiichi Sankyo is celebrating after its once-a-day blood thinner edoxaban proved as effective as warfarin in a late-stage trial, although it faces stiff competition from recently-launched rivals.

It is a potentially lucrative market, with relatively new treatments - such as Bayer’s Xarelto and Boehringer Ingelheim’s Pradaxa - set to make $10 billion as replacements for warfarin, which has been in common use for decades but which requires careful monitoring.

The Phase III Hokusai-VTE trial encompassed more than 8,000 patients - including some with severe PE - one arm of which received the direct factor Xa-inhibitor and the other warfarin. Both groups had initial treatment with heparin.

Edoxaban had a lower incidence of recurrent symptomatic venous thromboembolism (VTE) (3.2% versus 3.5%) and was superior to warfarin for the pre-specified principal safety outcome of clinically relevant bleeding (8.5% versus 10.3 per cent).

VTE is an umbrella term for two conditions: deep vein thrombosis (DVT) and PE (pulmonary embolism), the first of which is a clot in the veins of the legs, the second occurring when part of a clot detaches and lodges in the pulmonary arteries, causing a potentially fatal condition.

“A promising finding was the sizeable reduction in recurrent symptomatic VTE among patients with severe PE who were treated with edoxaban,” explained Harry Büller, chairman of the Department of Vascular Medicine at the Academic Medical Center in Amsterdam.

 Daiichi Sankyo now plans to submit the drug for authorisation in VTE by the first quarter of 2014 in the US, Europe and Japan.

It has only been approved in Japan since April 2011 for the prevention of VTE after major orthopedic surgery under the brand name Lixiana.

VTE is believed to be a factor in 540,000 deaths each year in Europe and 300,000 in the US: a third of VTE sufferers die within one month of diagnosis and 20% with PE experience sudden death.

The manufacturer is also going to present data from the Phase III ENGAGE AF-TIMI 48 study in patients with atrial fibrillation at the 2013 American Heart Association Scientific Sessions in November.

Adam Hill

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