Dr. Murray A. Mittleman, director of the Cardiovascular Epidemiology Research Unit at Beth Israel Deaconess Medical Center at Harvard Medical School in Boston, said finding alternate treatments for DVT could be an "important advancement," even though rivaroxaban is likely to be a more expensive option.
"The problem with current treatments is not cost," he noted, "in the sense that warfarin, for example, has been around for a very long time and is very cheap. It's more a question of the considerable complications that come with current treatments, which means they require sometimes cumbersome and frequent monitoring, as well as dosage adjustments."
Kadish agreed. "While the cost of rivaroxiban is significant, the absence of monitoring costs, reduced time away from work [since blood test are not required] and the lower bleeding rate all serve to mitigate the cost differential relative to warfarin," he said.
"Also, DVT affects a broad age range of patients," Mittleman noted. "And that means that the risk for bleeding with current treatments can impact the lifestyles of young active people who are often advised to avoid activities that might prompt complications. So, it's a quality-of-life issue as well. So absolutely, a new, good treatment that would be safer and at least as effective would be very useful."
There's more on DVTs at the U.S. National Heart, Lung, and Blood Institute.
SOURCES: American Society of Hematology, news release, Dec. 4, 2010; New England Journal of Medicine, Dec. 4, 2010; Alan Kadish, M.D., cardiologist and president, Touro College, New York City; Murray A. Mittleman, M.D., director, cardiovascular epidemiology research unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston
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