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The Use of Dabigatran in Elderly Patients

The Use of Dabigatran in Elderly Patients CLINICAL OBSERVATION Matthieu Legrand, MD; Joaquim Mateo, MD; Alice Aribaud; Sixtine Ginisty, MD; Pirayeh Eftekhari, MD; Patrice Tran Ba Huy, MD, PhD; Ludovic Drouet, MD, PhD; Didier Payen, MD, PhD ecent approval by the US Food and Drug Administration (FDA) of dabigatran etexi- late, an oral direct thrombin inhibitor, for the prevention of stroke in patients with atrial fibrillation will likely extend its administration in elderly patients. The risk of R major overdosage of dabigatran etexilate in this population is, however, much in- creased owing to frequent renal function impairment, low body weight, drug interactions that can- not be detected with a routine coagulation test, and no antagonist available. We report herein 2 clinical cases, including 1 fatal case, illustrating our concern regarding the risk of bleeding events in elderly patients. Arch Intern Med. 2011;171(14):1285-1288 On October 19, 2010, the US Food and Oise, France). The drug causality was as- Drug Administration (FDA) approved sessed using an imputability score dabigatran etexilate for the prevention of approved by the World Health Organiza- stroke and blood clots in patients with tion Collaborating Centre for Interna- atrial fibrillation (AF). This approval fol- tional Drug Monitoring. lows the publication of the Randomized Evaluation http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

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Publisher
American Medical Association
Copyright
Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/archinternmed.2011.314
pmid
21788545
Publisher site
See Article on Publisher Site

Abstract

CLINICAL OBSERVATION Matthieu Legrand, MD; Joaquim Mateo, MD; Alice Aribaud; Sixtine Ginisty, MD; Pirayeh Eftekhari, MD; Patrice Tran Ba Huy, MD, PhD; Ludovic Drouet, MD, PhD; Didier Payen, MD, PhD ecent approval by the US Food and Drug Administration (FDA) of dabigatran etexi- late, an oral direct thrombin inhibitor, for the prevention of stroke in patients with atrial fibrillation will likely extend its administration in elderly patients. The risk of R major overdosage of dabigatran etexilate in this population is, however, much in- creased owing to frequent renal function impairment, low body weight, drug interactions that can- not be detected with a routine coagulation test, and no antagonist available. We report herein 2 clinical cases, including 1 fatal case, illustrating our concern regarding the risk of bleeding events in elderly patients. Arch Intern Med. 2011;171(14):1285-1288 On October 19, 2010, the US Food and Oise, France). The drug causality was as- Drug Administration (FDA) approved sessed using an imputability score dabigatran etexilate for the prevention of approved by the World Health Organiza- stroke and blood clots in patients with tion Collaborating Centre for Interna- atrial fibrillation (AF). This approval fol- tional Drug Monitoring. lows the publication of the Randomized Evaluation

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Jul 25, 2011

References