Replies to post #126281 on Biotech Values

[iwfal]

I don’t for a minute believe that “skillful” use of warfarin is better for AF patients than Xarelto. This is an instance of a bad pivotal trial, not a bad drug (echoing what Dr. Pazdur once said about Erbitux).

I don't know too much about Xarelto - but I did some extensive review of the Pradaxa data for an acquaintance thinking of switching and I think it is pretty clear that with diligent care most patients would do better on Warfarin than Pradaxa. E.g. the rate of non-compliance (particularly not testing as frequently as past deviations indicate the patient should) is pretty high.

That said, of course:

1) most patients are not, and never will be, particularly diligent. (the CRXX data and other data I've seen gave surprisingly large percentages of patients in real-world use that lapse with regularity)

2) there are some patients who, for whatever reasons (e.g. genetic or concomitant conditions/drugs) are inherently erratic in their INR.