Harvard Health Ad Watch: A blood thinner winner?

A magnified view that shows a blood clot occurs and where it might occur in blood vessels inside the calf

Usually, our blood is designed to clot when essential to forestall each minor reduce or bruise from turning into a life-threatening hemorrhage. A fancy system of blood cells, proteins, and blood vessels retains blood flowing correctly and prevents clotting — besides in the correct time and place. But sure well being issues typically trigger blood clots in arteries or veins, which may set off life-threatening issues. To assist deal with or forestall irregular blood clots, medical doctors might prescribe medicines generally known as blood thinners.

Fairly seemingly you’ve seen advertisements for one such drugs, Eliquis (apixaban), which can be popping up all over the place. As is true with most advertisements for medicines, the knowledge offered could also be enlightening, however it could even be complicated. And there could also be different related data that’s lacking. Let’s check out one advert that’s been in heavy rotation. (This advert solely discusses utilizing Eliquis for blood clots in veins that may trigger critical issues. It doesn’t talk about taking Eliquis for a coronary heart rhythm downside known as atrial fibrillation.)

What’s across the nook?

A frightened girl draped in shadows walks down the block and reaches a nook. As ominous music performs, a voiceover explains: “After my DVT blood clot, I puzzled: is one other one across the nook?” Now, the music turns mild and uplifting. Solar shines down because the voice goes on: “Or may it’s totally different than I believed? I wished to guard myself. My physician really helpful Eliquis.”

The voiceover continues: “Eliquis is confirmed to deal with and assist forestall one other DVT or PE blood clot. Virtually 98% of sufferers on Eliquis didn’t expertise one other. And Eliquis has considerably much less main bleeding than one other normal remedy.”

The dangers of taking Eliquis

Among the many data the FDA requires in drug advertisements is an announcement of a very powerful dangers. A critical male voice says, “Eliquis may cause critical and in some circumstances deadly bleeding. Don’t take Eliquis when you have a man-made coronary heart valve or irregular bleeding.” We’re additionally warned about issues which may comply with spinal injections, simple or uncommon bruising, extreme or extended bleeding, and better threat of bleeding with some medicines. Your physician must find out about any deliberate medical or dental procedures.

All through this recital, the visuals are distractingly interesting: a cheerful couple drives and hikes via breathtaking panorama.

The large end

The frightened girl is clearly in a greater place now: “What’s across the nook could possibly be stunning. Ask your physician about Eliquis.” As she rounds one other nook, she encounters just a little lady who’s blowing bubbles and runs into her arms. Candy ending, proper?

What to grasp about blood clots and blood-thinning medicines

Earlier than contemplating the professionals and cons of this advert, let’s speak about why some folks must take medicines like Eliquis within the first place.

Generally irregular blood clots happen in arteries, abruptly interrupting blood stream and triggering coronary heart assault or stroke. Clots can kind inside the guts, particularly if the guts’s rhythm is irregular, as with atrial fibrillation. They could additionally kind in veins (venous thromboembolism, or VTE). Clots in deep leg veins (deep vein thrombosis, or DVT) can journey via the bloodstream to the lungs, inflicting a life-threatening situation known as pulmonary embolus (PE). This will trigger shortness of breath, chest ache, and probably harmful reductions in blood oxygen ranges. As much as 100,000 folks within the US die of VTE/PE every year.

For long-term remedy to assist keep away from preliminary or recurring blood clots, folks take medicines known as blood thinners, such because the long-time normal warfarin (Coumadin), or newer choices like apixaban (Eliquis).

Warfarin has by no means been a simple drug to take. It requires frequent monitoring and interacts with many meals and different medication. The optimum dose can change inexplicably, so folks taking warfarin typically develop bleeding issues or blood clots, although their dose hasn’t modified.

New blood thinners have turn out to be obtainable lately. Apixaban (Eliquis) is without doubt one of the hottest. And, as is true for many new medicines, it’s costly — it prices practically $500/month — and closely promoted.

What the advert will get proper

  • Oral blood thinners, together with Eliquis, are extremely efficient and routinely really helpful after a DVT or PE. Therapy usually lasts not less than three months.
  • As with all blood thinners, the commonest, and probably critical, facet impact of Eliquis is bleeding. Minor bleeding, similar to nosebleeds or gum bleeding, is widespread, occurring in about 10% of individuals taking it. Main bleeding happens lower than 1% of the time.
  • There’s some proof that Eliquis might trigger much less minor and main bleeding than different, older blood thinners.

What else do it’s essential to find out about Eliquis?

  • In contrast with warfarin, Eliquis requires much less monitoring, interacts with fewer medicines, and has no dietary restrictions.
  • Different choices that could be equally efficient embody rivaroxaban (Xarelto), edoxaban (Savaysa), dabigatran (Pradaxa), and betrixaban (Bevyxxa). Dangers and advantages range, in response to two research evaluating rivaroxaban with apixaban (Eliquis). For instance, one research discovered fewer blood clots and fewer bleeding with apixaban.
  • Blood thinners aside from apixaban are really helpful for anybody pregnant who’s growing a blood clot, or individuals who have most cancers, synthetic coronary heart valves, or extreme liver or kidney illness.
  • Eliquis can also be authorised by the FDA for atrial fibrillation.

The underside line

Drug advertisements are supposed to promote a product. Whereas some helpful data is included, don’t rely on advertisements to be thorough, balanced, or unbiased. You and your physician ought to ensure you have the knowledge it’s essential to make a great determination about your medicines. Don’t go away that as much as the makers of Eliquis — or every other drug firm.

Comply with me on Twitter @RobShermling

Commenting has been closed for this put up.

Leave a Reply