After a heart attack, a drug like Coumadin can be a lifesaver. But life on Coumadin can be a royal pain.
"It's like having a mother-in-law; a nuisance but necessary," said Bill Knoblor, one of 3 million Americans taking the blood thinner Coumadin.
Like most of them, he suffers from atrial fibrillation - an irregular heartbeat. When the heart's chambers do not beat in sync, blood clots can form. Stroke is a major risk. Coumadin is the default prescription. But it's not without cost.
"There are major side effects with Coumadin," said cardiologist Dr. William Borden, of the Perelman Heart Institute at New York Presbyterian Hospital/Weill Cornell Medical Center, "the main one being bleeding."
That's because Coumadin needs to be closely watched. Sometimes it thins the blood too much, other times not enough. And that's not all.
"The hassle for patients is it interacts with different foods, it interacts with medicines and they have to get their blood tested about once a month," Borden said.
Now comes a major clinical study of a German drug; 18,000 patients from 44 countries, all suffering from irregular heartbeat, were studied for two years. The result: the German drug was three times more effective than Coumadin at reducing the risk of stroke without the need for frequent blood tests.
"This study is huge because all doctors, nurses and patients who need to take this have been waiting for a medication that doesn't need the constant checking and is not so variable that it puts them at risk," said cardiologist Chris Cannon.
A sweet dream for patients like Bill Knoblor.
"I'd be ecstatic if there were a replacement," he said.
The German drug is called Pradaxa. It has side effects, too - indigestion and a slightly greater risk of heart attack. But if it wins FDA approval, the drug could be a blockbuster. Experts say the market for oral anticoagulants could be $10 billion a year.