Number of patients taking dabigatran declines after first 4 months, study finds

Patients using the relatively new blood thinner dabigatran (Pradaxa, Boehringer Ingelheim) failed to remain on the treatment 17% of the time after the first 4 months, increasing their risk of stroke, according to a new study.

Researchers with Medco Research Institute presented the study at the American Heart Association’s Scientific Sessions 2011 in mid-November in Orlando.

Researchers examined the prescription claims between November 1, 2010, and December 31, 2010, of 1,143 patients who were prescribed dabigatran for up to 4 months of follow-up. Patients’ medical history for the 12 months prior to starting dabigatran included: stroke (10%), venous thromboembolism (5%), pulmonary embolism (5%), and valve replacement (2%).

“We are seeing a sizable portion of patients drop off treatment in a fairly short time. This is a twice-daily drug and stroke prevention outcomes may be particularly sensitive to how consistently patients take it, pointing to a need and opportunity to provide dedicated and proactive patient support,” said Dr. Eric Stanek, vice president of research at Medco.

As a result, Medco’s specialty pharmacists are working with patients who have gaps in their dabigatran therapy. “Our data show the importance of actively monitoring the course of therapy in patients taking dabigatran…Doctors and pharmacists need to regularly monitor persistence and discuss adherence to therapy with dabigatran,” said Dr. Donald Pittman, national practice leader of the Medco Cardiovascular Therapeutic Research Center.

Dabigatran is an alternative to the popular blood thinner warfarin. The study showed that warfarin therapy was prescribed in 71% of patients during the prior 6 months to starting dabigatran treatment, suggesting that prescribers are adopting dabigatran as an alternative to warfarin.