Pall T. Onundarson: This JACC Review is Highly Biased in Favor of DOAC Drugs
Pall T. Onundarson, Professor Emeritus at Landspitali University Hospital, shared a post on LinkedIn:
“Bruno, is careful in how he chooses his words but this JACC review is highly biased in favor of DOAC drugs, just look at the whole page list of disclosures. All the studies quoted compare DOAC drugs to conventional old PT-INR monitoring of warfarin that we know today is a suboptimal monitoring method that leads to suboptimal outcomes with warfarin.
Why does the paper not mention that there are major improvements in warfarin and VKA treatment and monitoring (self-monitoring and dosing, Fiix monitoring) that could benefit patients and payers massively? To whose benefit is it to silence that such improvements exist and deserve better study? What do patients and regulators think of not being made aware of such potential benefit by medical doctors? Why are reagent and instrument manufacturers afraid of investing in such improvements if patients and payers could benefit?”
Quoting Bruno Pougault’s post:
“DOACs may not be as efficacious or as safe as the current standard of care in conditions such as mechanical heart valves, thrombotic antiphospholipid syndrome, and atrial fibrillation associated with rheumatic heart disease”
Title: When Direct Oral Anticoagulants Should Not Be Standard Treatment: JACC State-of-the-Art Review
Authors: Antoine Bejjani, Candrika D Khairani, Ali Assi, Gregory Piazza, Parham Sadeghipour, Azita H Talasaz, John Fanikos, Jean M Connors, Deborah M Siegal, Geoffrey D Barnes, Karlyn A Martin, Dominick J Angiolillo, Dawn Kleindorfer, Manuel Monreal, David Jimenez, Saskia Middeldorp, Mitchell S V Elkind, Christian T Ruff, Samuel Z Goldhaber, Harlan M Krumholz, Roxana Mehran, Mary Cushman, John W Eikelboom, Gregory Y H Lip, Jeffrey I Weitz, Renato D Lopes, Behnood Bikdeli
Read full paper here.
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