However, many patients are not suitable candidates for. Study design1,2 the primary objective of the trial was to determine if apixaban was superior to asa for the prevention of the composite outcome of stroke or systemic embolism. We would like to show you a description here but the site wont allow us. In averroes, 5599 patients mean age 70 years with atrial fibrillation who were at increased risk of stroke and unsuitable for vitamin k antagonist therapy were randomly assigned to receive apixaban 5 mg twice daily or aspirin 824 mg per day. Modification of outcomes with aspirin or apixaban in. The safety and scientific validity of this study is the responsibility of the study sponsor. Stroke or systemic embolism primary safety outcome. His prowess in the field of medicine was established when he published kitab alkulyat fi altibb. The averroes trial compared apixaban with aspirin in 5599 patients with af who were at increased risk of stroke and for whom vitamin k antagonists were. Averroes confirms that oral anticoagulation should be. As a secondary analysis, we identified risk factors for stroke in the data set of the averroes trial among aspirin.
In the averroes trial, apixaban demonstrated superiority compared with aspirin in reducing the risk of strokes in patients with af. However, many patients are not suitable candidates for or are unwilling to receive vitamin k. Apixaban for reduction in stroke and other thromboembolic. Apixaban in patients with atrial fibrillation n engl j med 364. One previous trial in a similar patient population, active a. It was at the court of abu yaqub, that ibn first authored a commentary on the works of aristotle, the greek philosopher. The primary objective of the trial was to determine if apixaban was superior to asa. Efficacy and safety of apixaban compared with aspirin in the elderly. Stroke prevention in atrial fibrillation af has been challenging over decades, mostly due to a number of difficulties associated with oral vitamin k antagonists vkas, which have been the most effective stroke prevention treatment for a long time. Bleeding during treatment with aspirin versus apixaban in patients. Averroes clinical trial in averroes, eliquis apixaban demonstrated superior stroke systemic embolism prevention with a comparable rate of major bleeding vs. Averroes was a doubleblind trial including 5599 patients from 36 countries who were at increased risk for stroke because of the presence. The duration of eliquis exposure was 12 months for 9375 patients and 24 months for 3369 patients in the two studies. Commentaries by alexander of aphrodisias and by simplicius were frequent, but those by the arab averroes on the aristotelian works were ultimately the most influential.
A noninferiority trial of apixaban versus a vka warfarin is being conducted but does not address the large unmet need of af patients at risk of stroke who are. The realworld evidence generated from data collected in routine medical practice complements the clinical trial data we have for patients treated with eliquis, said dr. Apixabancalibrated antifxa activity in relation to outcome events. The 2011 apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin k antagonist treatment averroes trial randomized 5,599 patients with af thought to be unsuitable candidates for vka therapy to apixaban or aspirin. A phase iii study of apixaban in patients with atrial. Averroes s two arguments are teleological in nature and not cosmological like the arguments of aristotle and most contemporaneous muslim kalam theologians.
Averroes nct00496769 is a doubleblind, doubledummy, phase iii trial comparing apixaban 5 mg twice daily versus aspirin 81 to 324 mg once daily in. Is concomitant aspirin helping novel oral anticoagulants. Averroes is a doubleblind, doubledummy superiority trial of apixaban 5 mg twice daily 2. The safety of eliquis was evaluated in the aristotle and averroes studies see clinical studies 14, including 11,284 patients exposed to eliquis 5 mg twice daily and 602 patients exposed to eliquis 2. Averroes ibn rushd, influential islamic religious philosopher who integrated islamic traditions with ancient greek thought. Novel oral anticoagulants for stroke prevention in atrial. Apixaban vs warfarin in patients with atrial fibrillation 1 apixaban for reduction in stroke and other thromboembolic events in. Table e25 summary of efficacy for trial averroes cv185048. The aristotle trial demonstrated that fixeddose unmonitored apixaban compared with doseadjusted warfarin was associated with a similar. Rory oconnor, chief medical officer, pfizer internal medicine. It was a doubleblind, randomizedcontrolled trial comparing the use of apixaban with aspirin two thirds received lowdose aspirin for prevention of stroke or systemic.
Apixaban, which is being developed by bristolmyers squibb and pfizer, is undergoing phase iii testing in the ongoing expanse programa series of clinical trials that includes the averroes trial. Averroes befriended ibn zuhr and the latter took him under his wing. Averroes nct00496769 was a randomised, doubleblind, doubledummy study to assess the superiority of apixaban 5 mg bid vs aspirin. It was a doubleblind, randomizedcontrolled trial comparing the use of apixaban with aspirin two thirds received lowdose. Apixaban vs warfarin in patients with atrial fibrillation. Bleeding during treatment with aspirin versus apixaban in patients with atrial fibrillation unsuitable for warfarin. Concerning the eternity of the world the first proof the second proof the third proof the fourth proof the second discussion.
A phase iii study of apixaban in patients with atrial fibrillation averroes. Acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have. Efficacy and safety of apixaban compared with aspirin in. The translations of the greek writings were normally accompanied by many greek and arabic commentaries. The goal of the apixaban versus acetylsalicylic acid to prevent strokes averroes trial was to determine if apixaban is a better choice compared with aspirin for the prevention of stroke in patients with atrial fibrillation. National drug may 20 va pharmacy benefits management. The apixaban versus acetylsalicylic acid asa to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin k antagonist treatment averroes trial included 5599 patients with af and risk factors randomized to either aspirin 824mg or apixaban.
Apixaban in patients with atrial fibrillation nejm. Averroes upholds the doctrine of divine unity and argues that god has seven divine attributes. The averroes trial is investigating apixaban compared to aspirin in approximately 5,600 patients with atrial fibrillation who are ineligible for vitamin k. Risk benefit of apixaban and other new oral anticoagulants.
As averroes was concluding, the longterm openlabel extension ltole study was. The acropolis program and its continued growth is a pivotal part of the bmspfizer alliances. The principal objective of the present analysis was to assess the effect of treatment with aspirin or apixaban on ischemic stroke, in relation to sex. New anticoagulants and the future of cardiology revista. However, a closer look at the dose of aspirin used in this trial seems to question the validity of the results.
We will here briefly discuss the clinical implications of the trial. The incoherence of the incoherence averroes ibn rushd etext conversion muhammad hozien. The averroes doubleblinded, randomized trial demonstrated that apixaban reduces the risk of stroke or systemic embolism sse by 55% compared with aspirin without an increase in major bleeding in patients with atrial fibrillation either who previously tried but failed vitamin k antagonists vka therapy or who were expected to be unsuitable for vka therapy. He wrote commentaries on plato and aristotle and defended philosophical study of religion against theologians such as alghazali, who had attacked muslim philosophers avicenna and alfarabi. Bristolmyers squibbpfizer alliance acropolis realworld.
Averroes trial in early 2011, the apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin k antagonist treatment averroes trial was published. Apixaban vs aspirin in atrial fibrillation classics series. Bleeding events were defined as the first occurrence of either. The apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin k antagonist treatment averroes trial randomized 5599 patients with atrial fibrillation and risk factors to receive either apixaban or aspirin. A phase iii study of apixaban in patients with atrial fibrillation full.
Apixaban triumphs over aspirin for stroke prevention in. Among patients with atrial fibrillation with recent acs or pci in the augustus trial, adding apixaban to a p2y 12 inhibitor resulted in lower bleeding compared with vka with a lower rate of death or rehospitalization. Averroes trial, a randomized, doubleblind, multinational superiority trial where apixaban was compared to aspirin in patients considered unsuitable for warfarin. Antithrombotic therapy after acute coronary syndrome or. In early 2011, the apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin k antagonist treatment averroes trial was published. It was a doubleblind, randomizedcontrolled trial comparing the use of apixaban with aspirin two thirds received lowdose aspirin for. Averroes, a randomized trial in highrisk patients with atrial fibrillation, unsuitable for vitamin k antagonist therapy, demonstrated the efficacy and safety of apixaban compared to aspirin for stroke prevention. Averroes exposition of religious arguments great islamic writings averroes, najjar, ibrahim on. In the averroes trial, that also evaluated eliquis in patients with atrial fibrillation but when compared to asa, 23% had other valvular disease of a similar nature to that described just above in the aristotle trial. Background vitamin k antagonists have been shown to prevent stroke in patients with atrial fibrillation. Thus, a clear superiority of apixaban over aspirin was shown in terms of efficacy, with comparable safety. The averroes trial compared the efficacy of apixaban 5 mg twice daily with aspirin 824 mg once daily for prevention of stroke and systemic embolism in 5599 patients with af who were considered unsuitable for vka treatment. In both arms, addition of aspirin resulted in greater bleeding without any difference in efficacy.
New data is presented on investigational oral anticoagulant apixaban in acute coronary syndrome patients. The refutation of their theory of the incorruptibility of. Bleeding during treatment with aspirin versus apixaban in. Apixaban to prevent stroke in patients with atrial.
25 35 55 1060 273 1545 51 385 1397 1297 994 538 879 67 1438 1358 926 1558 1179 1339 285 423 103 4 711 605 1064 289 912 992 722 1482 1155 464 1559 1066 1262 226 769 660 684 553 376 883 889 1070 1002