Diagnosis of recurrent DVT and PE: A patient’s guide to the clinical care guidance used by healthcare professionals
Beth Waldron, Clot Connect program director, writes…
If you’ve experienced deep vein thrombosis (DVT) or pulmonary embolism (PE), a recurrence of a blood clot in the future is a concern. Diagnosing a recurrent clot can be a challenge because it is sometimes difficult to tell if symptoms are the result of a new clot or the signs of chronic damage from the initial clot.
- Around 40% of patients with DVT develop long-term pain and swelling, known as post-thrombotic syndrome. Such pain and swelling can fluctuate, and be particularly pronounced after standing for prolonged periods of time or being overly active.
- Around 4% of patients with PE develop long-term shortness of breath, known as pulmonary hypertension.
How do healthcare professionals know when symptoms are the result of a past blood clot or due to a new clot? Read the rest of this entry »
Reversal Agent for Eliquis – Early Clinical Study Results
Stephan Moll, MD writes….
The pharmaceutical company Portola reported today (May 8th, 2013) on the findings of their human volunteer study of their blood thinner antidote PRT4445 (ClinicalTrials.gov Identifier: NCT01758432 – medical details of the study design are here, study NCT01758432. This dug is in early development. In the study, healthy volunteers who had taken the new oral blood thinner Eliquis (Apixaban) received the reversal agent. The study showed a “rapid and sustained and dose-related reversal” of the blood thinning effect of Eliquis” and “no serious adverse events”. Read the rest of this entry »
Natural supplements, herbs, vitamins and food: do any prevent blood clots?
Beth Waldron, Clot Connect Program Director and Stephan Moll, MD, Clot Connect Medical Director write….
Patients who have ended their recommended course of prescription anticoagulation treatment are understandably concerned about a clot recurrence and will ask “is there anything I can do to prevent a future clot?” Some have heard from friends or the internet that a particular herb, vitamin, or food will aid in the prevention of DVT and PE.
Since more than half of adults in the United States take a dietary supplement of some kind, it may be helpful to examine the science behind some of the most common natural supplements and foods said to prevent blood clots.[1] Read the rest of this entry »
Kcentra – FDA Approval of New Drug for Reversal of Warfarin
Stephan Moll, MD writes… A new drug for the urgent reversal of warfarin was approved by the FDA today, April 29th, 2013, (announcement by the FDA is here), called Kcentra. Read the rest of this entry »
Testing for Clotting Disorders – Can It Be Done While on Blood Thinners?
Stephan Moll, MD writes… The decision how long to treat a patient who has had a DVT or PE with blood thinners can often be made based just on the patient’s history. Often no testing for clotting disorders (thrombophilias) is needed. The decision how long to treat is influenced by 3 factors: (1) What is the person’s risk of another clot if he/she is not on blood thinners any more? (2) What is the person’s risk for bleeding on blood thinners? (3) What is the person’s own preference regarding his/her treatment. These issues are discussed in detail here.
However, if one were to do testing, what is the right time to test? It is important to know that some blood thinners can influence test results.
New Clots in Spite of Being on Warfarin – “Warfarin Failure”
Stephan Moll, MD writes…
Occasionally, new blood clots (DVT or PE) develop in spite of a patient being on warfarin (Coumadin, Jantoven). This happens particularly in patients with Read the rest of this entry »
Top clinically relevant publications for patients from 2012
Beth Waldron and Stephan Moll, MD write….
While much is known about blood clots and clotting disorders, there is still much being learnt. Medical information changes over time as new clinical trials, research studies and evidence-based guidelines contribute to knowledge of and treatments for blood clots and clotting disorders. Many of today’s standards of treatment are based upon what was learned from publications in the past.
Over the past year, a number of publications emerged which will influence future clinical decisions and potentially impact your care. Here is a summary of the ‘top clinically relevant publications from 2012’ and how they may affect you. Read the rest of this entry »
Eliquis (Apixaban) – What Your Physician Wants to Know
Stephan Moll, MD writes…
Apixaban (Eliquis) is one of the 3 new oral blood thinners. It is NOT approved at this point to prevent or treat DVT or PE (also referred to as venous thromboembolism or VTE). It is, however, FDA-approved for the use in patients with irregular heart beat (atrial fibrillation) to prevent stroke. As the studies on VTE have not been completed and as the drug is not FDA-approved for VTE, I would NOT use it off label in patients with VTE. However, for the health care professionals who prescribes apixaban for atrial fibrillation, we have made available the apixaban guideline (here) Read the rest of this entry »
Xarelto – What Your Physician Wants to Know
Stephan Moll, MD writes…
If you are considering to start therapy with the new oral “blood thinner” Xarelto (Rivaroxaban), there are a few safety nets that your local hospital and physician may want to establish to make therapy as safe as possible for you
. Issues to be addressed are (a) dosing, (b) management of major bleeding, (c) interruption of therapy for surgery, dental procedures, and other procedures, and d) what to do if you missed a dose.
These issues are probably best addressed by the establishment of a treatment algorithm/guide for the entire hospital or physician practice. Read the rest of this entry »
New Blood Thinner (Eliquis = Apixaban) FDA Approved
Stephan Moll, MD writes… Another new oral blood thinner (Eliquis = apixaban) was approved by the FDA on Dec 28th, 2012 – to be used by patients with irregular heart beat (atrial fibrillation) to prevent stroke. The drug is NOT yet FDA-approved for treatment of patients with DVT or PE. Clinical trials evaluating Eliquis for this indication are still ongoing. Read the rest of this entry »