Age linked to increase in GI bleeding risk associated with oral anticoagulants

[EngMac]

As time goes on and NOAC's are used more often, studies look at the impact. This is one.

healio.com/gastroenterology...

[Hidden]

Oh dear. I was just going to ask my EP tomorrow if I could go onto NOAC's as my INR just jumped from 2.2 to 3.4 in a few weeks. But at age 64.9, maybe best to stay with Warfarin?

Thanks for the post.

Koll

[Finvola]

I notice there is no mention of Apixaban - wonder if it wasn't tested or didn't have the same effects?

[CDreamer]

My understanding is that this was well known in 2013 and that the companies reviewed and changed the dosage for patients over 75years. It says that this is the first study to look at the evidence in the 'real world', I assume that this is therefor not just a trial but reported bleeds. Before my GP prescribed he told me he did a lot of research and when he looked at the consequences found that although the number of people reporting bleeds was more than Wafarin, the severity was less and the outcomes were positive in people who were otherwise healthy.

I think that we must remember that often by the age of 75 we often have other complaints and my decision to take Dabigatron was based on advice from both my GO and EP that GI bleed was far preferable to a brain bleed which studies have shown to be less in the over 75 population to those taking Wafarin. I hasten to add that I haven't reached that age yet but my husband has been taking Dabigatron for 12 months at the age of 80 and pleased to say with no ill effects.

That should read GP not GO, I seem unable to return to previous statements to edit, sorry.

Thanks for the link, it is reassuring that things are constantly reviewed.

[BobD Volunteer]

I think I have mentioned before that there is a point in age where it is often preferable NOT to be on anticoagulation. One MUST balance HASBLED against CHADSVASC when making choices about anticoagulation whatever drug is used and the risk of bleed increases with age in many cases regardless of which drug is used. The "study" does suggest that NOACs have a slightly great risk in this regard but surely they start with less risk in the first place. It is all about balance in my view and whilst I am very happy to take warfarin as I have for ten years I think it important NOT to scare people off NOACs as seems to be the case a lot in USA with all the class actions etc. I am sure that they are quite safe so long as all the correct balance is maintained and they are not prescribed to unsuitable patients.

Bob

[MarkS]

It's interesting that the "real world" results of dabigatran don't reflect as well as the RELY trial which originally led to its approval. I guess this was bacause the original trial was very strictly controlled and designed to produce the results the manufacturer wanted.

Mark

[Offcut]

And just when you think it is all sorted out, another spanner is thrown?