The Pharmaceutical Journal
Vol 274 No 7336 p171
12 February 2005

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JAMA: Ximelagatran — Promises and Concerns (2005;293;736)

Ximelagatran as effective as warfarin but not cost effective

The anti-clotting drug ximelagatran (Exanta) may be as effective as warfarin for the treatment of deep vein thrombosis and the prevention of stroke in patients with atrial fibrillation, but it is unlikely to be cost effective.

Two studies published in JAMA this week, the THRIVE trial and the SPORTIF V trial (PJ, 13 December 2003, p806), demonstrated positive results for ximelagatran for the the treatment of deep vein thrombosis and the prevention of stroke in patients with atrial fibrillation, respectively, although concerns were raised over the increase in liver enzymes seen in ximelagatran patients (JAMA;2005:681).

However, a third paper states that ximelagatran is only likely to be a cost-effective alternative to warfarin in patients with atrial fibrillation and a high bleeding risk, or those who have a low quality of life taking warfarin (ibid p699).