Beth Waldron and Stephan Moll, MD write….
While much is known about blood clots and clotting disorders, there is still much being learnt. Medical information changes over time as new clinical trials, research studies and evidence-based guidelines contribute to knowledge of and treatments for blood clots and clotting disorders. Many of today’s standards of treatment are based upon what was learned from publications in the past.
Over the past year, a number of publications emerged which will influence future clinical decisions and potentially impact your care. Here is a summary of the ‘top clinically relevant publications from 2012’ and how they may affect you. Read the rest of this entry »
Stephan Moll, MD writes…
Apixaban (Eliquis) is one of the 3 new oral blood thinners. It is NOT approved at this point to prevent or treat DVT or PE (also referred to as venous thromboembolism or VTE). It is, however, FDA-approved for the use in patients with irregular heart beat (atrial fibrillation) to prevent stroke. As the studies on VTE have not been completed and as the drug is not FDA-approved for VTE, I would NOT use it off label in patients with VTE. However, for the health care professionals who prescribes apixaban for atrial fibrillation, we have made available the apixaban guideline (here) Read the rest of this entry »
Stephan Moll, MD writes…
If you are considering to start therapy with the new oral “blood thinner” Xarelto (Rivaroxaban), there are a few safety nets that your local hospital and physician may want to establish to make therapy as safe as possible for you. Issues to be addressed are (a) dosing, (b) management of major bleeding, (c) interruption of therapy for surgery, dental procedures, and other procedures, and d) what to do if you missed a dose.
These issues are probably best addressed by the establishment of a treatment algorithm/guide for the entire hospital or physician practice. Read the rest of this entry »
Stephan Moll, MD writes… Another new oral blood thinner (Eliquis = apixaban) was approved by the FDA on Dec 28th, 2012 – to be used by patients with irregular heart beat (atrial fibrillation) to prevent stroke. The drug is NOT yet FDA-approved for treatment of patients with DVT or PE. Clinical trials evaluating Eliquis for this indication are still ongoing. Read the rest of this entry »
Beth Waldron, Program Director of Clot Connect, writes….
The claim: In a recent newspaper article (ref 1), it was stated that “grapefruit eaten in ordinary amounts can interact harmfully with some common prescription drugs”. Among the drugs listed is the oral anticoagulant Xarelto® (rivaroxaban). Read the rest of this entry »
Stephan Moll, MD writes… An important study (ASPIRE trial), relevant for patients with a history of DVT or PE, was published this week (Nov 22nd, 2012) in the New England Journal of Medicine [ref 1] . It showed that aspirin is not effective in preventing further DVT or PE in patients who have had a previous unprovoked (= idiopathic) DVT or PE and who have completed standard length (often considered to be 3-6 months) of blood thinner (warfarin) therapy. However, aspirin still had some benefit – it decreased the occurence of “vascular events” (i.e. a conglomerate of heart attacks, strokes, and DVT and PE when all were grouped together). Aspirin did not lead to an increase in risk of major bleeding. Read the rest of this entry »
Stephan Moll, MD writes…
Today is a very exciting day for patients with blood clots and for health care professionals looking after such patients: the oral blood thinner Xarelto® (Rivaroxaban) was FDA approved today (Nov 2nd, 2012) for the use in patients with DVT (deep vein thrombosis) and PE (pulmonary embolism). The FDA announcement can be read, here. Why is this exciting? Because therapy with Xarelto is much easier than the often cumbersome therapy with warfarin. The reasons for this are discussed below. Read the rest of this entry »
Beth Waldron, Program Director of Clot Connect, writes…
The claim: “Eating lunch at your desk could increase your risk of DVT”—was the dramatic headline from UK’s Marie Claire magazine which caught my attention. (1) The online story went on to say that “Almost 75 per cent of office staff aged 21-30 who work 10-hour days don’t get up to take a break. This could double chances of a fatal blood clot.” The story was light on citing scientific evidence to back up this claim, so, as someone interested in DVT education (and admittedly, who eats at her desk routinely), I decided to investigate if this assertion is true: Does eating lunch at your desk increase blood clot risk? Read the rest of this entry »
Some persons have either a genetic (inherited) or acquired predisposition to develop blood clots, known as a thrombophilia or clotting disorder. There are several types of thrombophilias which contribute to varying degrees of clot risk. Read the rest of this entry »
This post begins the first in a series addressing the most commonly asked questions by patients.
“When will my clot and pain go away?” is a question commonly asked following diagnosis of deep vein thrombosis (DVT) or pulmonary embolism (PE). Read the rest of this entry »