Nature Reviews Drug Discovery 11,434 (2012).
The US Food and Drug Administration (FDA) approval of Boehringer Ingelheim’s dabigatran for stroke prevention in atrial fibrillation last year was a key success in a long hunt for oral anticoagulants. A year and a half on,however,the drug’s place in the anticoagulant armamentarium still remains unclear. The jury is out on how the direct thrombin inhibitor fares versus warfarin in the real-world setting,and how it stacks up against oral factor Xa inhibitors like Bayer’s rivaroxaban and Bristol-Myers Squibb/Pfizer’s apixaban (the FDA is due to rule on approval for apixaban in June). To answer these questions,Boehringer Ingelheim has now launched one of the world’s largest registries,GLORIA-AF,to follow the use of anticoagulants — including dabigatran and its competitors — in 56,000 patients. Co-chairing the steering committee of the study is Gregory Lip,a cardiologist at the University of Birmingham Centre for Cardiovascular Sciences,UK. He discusses the changing anticoagulant landscape with Asher Mullard.