Angiomax works just as well as heparin - study

As the commonly used blood thinner heparin is recalled around the world and some doctors worry about shortages, researchers say the anti-clotting drug Angiomax works just as well.

A study released on Saturday found the two drugs worked about the same in low- to moderate-risk patients in preventing death, heart attack and the need to repeat medical intervention on a diseased blood vessel. The study, which was paid for by Nycomed Pharma of Germany, did not include high-risk patients.

“They are not that much different,” said Dr. Adrian Kastrati, who led the study and presented the findings at a joint meeting of the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions in Chicago.

Angiomax, generically known as bivalirudin and made by the Medicines Cos, is far more expensive than heparin, produced by Baxter International Inc.

Kastrati said the premium price tag doesn’t mean Angiomax is a superior product.

Angiomax may be a better alternative for those patients who are at a high-risk for bleeding, he said, because heparin caused more bleeding.

But “there should be a thorough investigation to identify those subgroups of patients who would benefit from one drug or the other,” Kastrati said in an interview.

It could be that heparin is better for those at risk of restricted blood supply to the heart, while Angiomax works best for those at risk for bleeding, he said.

“That needs to be validated with data,” he added.

Baxter’s heparin has been linked to at least four deaths and hundreds of adverse events, and is the subject of a U.S. Food and Drug Administration investigation focused in part on a Chinese plant that supplies the raw active ingredient for the drug.

Heparin is derived from pig intestines and is used in dialysis and heart procedures, among other surgeries, to prevent blood clots.

Some doctors worry there won’t be enough heparin to go around amid the recall.

“We are expecting a shortage,” said Dr. Alvin Schmaier, chief of hematology/oncology at University Hospitals Case Medical Centers. He said his hospital has commenced a program to educate the faculty and staff about alternatives.

“Angiomax is a fine and safe alternative where cost is not an issue,” Schmaier said.

Heparin “is still a mainstay at a cost of about 12 cents a day, compared with Angiomax at $150 to $350 per day,” he said.

Dr. Lloyd Klein, a cardiologist and professor of medicine at Rush Medical Center, said, “We would all like to dump heparin. It’s impure and the potential (for contamination) has always been there, but it’s there because it’s a lot cheaper and almost as good.”