Antithrombotic dose: some observations from published clinical trials

Research output: Contribution to journalArticle

Authors

  • Simon Dimmitt
  • Christopher Floyd
  • Robin Ferner

Colleges, School and Institutes

External organisations

  • King's College London
  • University of Western Australia

Abstract

The clinical doses of antithrombotics-antiplatelet and anticoagulant agents-need to balance efficacy and safety. It is not clear from the published literature how the doses currently used in clinical practice have been derived from preclinical and clinical data. There are few large randomised controlled trials (RCTs) that compare outcomes with different doses vs placebo. For newer antithrombotics, RCT doses appear to have been chosen to maximise the probability of demonstrating noninferiority when compared to established agents such as warfarin or clopidogrel. Data from RCTs show that aspirin is an effective antithrombotic at doses below 75 mg daily, and that direct oral anticoagulants reduce the risk of stroke in patients with coronary disease at doses 1/4 of those recommended in atrial fibrillation. Lower doses than those currently recommended are safer and still maintain substantial efficacy.

Bibliographic note

© 2019 The British Pharmacological Society.

Details

Original languageEnglish
Pages (from-to)2194-2197
Number of pages4
JournalBritish Journal of Clinical Pharmacology
Volume85
Issue number10
Early online date1 Jul 2019
Publication statusPublished - 1 Oct 2019

ASJC Scopus subject areas