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Efficacy and Safety of Dabigatran vs. Warfarin in Patients with Atrial Fibrillation - Japanese population in the RE-LY ® - Shinya Goto, MD., PhD. Tokai.

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Presentation on theme: "Efficacy and Safety of Dabigatran vs. Warfarin in Patients with Atrial Fibrillation - Japanese population in the RE-LY ® - Shinya Goto, MD., PhD. Tokai."— Presentation transcript:

1 Efficacy and Safety of Dabigatran vs. Warfarin in Patients with Atrial Fibrillation - Japanese population in the RE-LY ® - Shinya Goto, MD., PhD. Tokai University School of Medicine C. Michael Gibson, M.S., M.D. Beth Israel Deaconess Medical Center, Harvard Medical School, Duke Clinical Research Institute

2 Dabigatran etexilate has been shown to concurrently reduce both thrombotic and haemorrhagic events Both doses of dabigatran provide different and complementary advantages over warfarin –150 mg BID showed 35% statistically significant reduction in stroke/systemic embolism with similar bleeding –110 mg BID showed comparable rates of stroke/systemic embolism has significantly less bleedings with similar efficacy RE-LY ® - Overall Summary

3 RE-LY ® - Baseline Characteristics in Japanese Population CharacteristicOverallJapan Randomized18,113326 Mean age (years)71.571.2 Male (%)63.676.7 CHADS 2 score (mean) 0-1 (%) 2 (%) 3+ (%) 2.1 31.9 35.6 32.5 2.2 31.3 34.0 34.7 Prior stroke / SEE / TIA(%)21.833.1 Prior MI (%)16.65.5 CHF (%)32.031.0 Baseline ASA (%)39.835.9 VKA naive (%)50.456.1 Hori M, et al: Circ J 2011; 75: 800 - 805, 2011

4 RE-LY ® - Stroke or Systemic Embolism OverallJapan % per year 150mg bid 110mg bid (n=134/6,076) (n=183/6,015) (n=202/6,022) % per year 150mg bid 110mg bid (n=1/111) (n=12/107) (n=4/108) RR 0.90 (95% CI: 0.74-1.10) RR 0.65 (95% CI: 0.52-0.81) RR 0.52 RR 0.25 Connolly SJ, et al.: N Engl J Med 363, 1875-1876, 2010 Hori M, et al: Circ J 2011; 75: 800 - 805, 2011

5 RE-LY ® - Plasma Concentration of Dabigatran in Overall and Japanese Overall Japanese Cpre,ss: Pre dose plasma concentrations at steady state C2,ss : Plasma concentration at 2 hours after drug administration at steady state (approximate maximum plasma concentration) Hori M, et al: Circ J 2011; 75: 800 - 805, 2011

6 Country Distribution of Mean Time in Therapeutic Range (TTR) in the RE-LY® Wallentin L, et al.: Lancet, 376: 975-83, 2010

7 RE-LY ® - INR Control / TTR RegionNINR <2INR 2-3INR>3 Overall5,78922.2%64.4%13.5% Japan10836.8%57.6%5.6% JCS guideline for pharmacotherapy of atrial fibrillation 2008: 2.0~3.0 for <70 years 1.6~2.6 for ≧ 70 years RE-LY in Japanese subgroup adapts INR 2.0-3.0 for <70 years and INR 2.0-2.6 for ≧ 70 years

8 The result of Japanese subgroup is basically consistent with overall results of RE-LY ®. The demographics of the Japanese subgroup differ from the overall population in prior stroke and MI of RE-LY but the overall risk score is similar. PK profile between Japanese subgroup and overall is similar. Based on the Japanese guideline criteria, the INR control of warfarin was well- controlled. RE-LY ® - Conclusions


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