In a 2016 blog, I quoted Dr. John Mandrola when he asked the billion-dollar question “Could Ablation for AFib be an Elaborate Placebo.” Now Dr. Mandrola is weighing in on a recent blood thinner trial. His commentary is on Medscape titled “The COMPASS Trial: Time for Clear Heads, Not Celebration.” I became critical of the trial immediately because it doesn’t study the blood thinner Xarelto against a placebo but against itself at a different dose. The drug makers give you a pretend choice of one drug!
Madrola says “The makers of rivaroxaban and the clinical trialists won big. Patients, not so much.” The drug trial …”earned top billing in the world’s biggest medical meeting, publication in the New England Journal of Medicine.” However, when the numbers are broken down the study’s “gain of 1.3% means more than 98% of people who take this combination get the same result as those who took aspirin alone.” This is a huge indictment of Xarelto itself!
Also, because COMPASS was terminated early we don’t even know if the tiny effects that were seen are stable. And quite extraordinarily “the 1.2% increase in major bleeding nearly exactly balances the gain. The authors downplay this side effect because they report that fatal bleeding was not increased.” Sheesh! Madrola was honest enough to say “That sort of interpretation approaches spin.” Exactly how do you spin away a serious bleed – fatal or not!
Madrola’s final concern is the amount of drugs the patients in the trial were taking. He says “The average patient in COMPASS was 68 years old with established vascular disease. In addition to aspirin, about 70% of patients in this trial took beta-blockers and ACE inhibitors; more than 90% took statins. That’s a lot of pills, and it does not count the pills patients take for other conditions. COMPASS proponents now want us to add another expensive (and you know it will be expensive) twice-daily drug to the concoction. This is not sustainable. Not for these benefits and harms.”
Personally I’m concerned about the existing magnesium deficiency in this vascular disease population, which will be accentuated with the use of more medications.
Of course, my recommendation for treating magnesium deficiency is to take ReMag which is 100% absorbed at the cellular level. Although I can’t make medical recommendations for natural blood thinners, I personally am reading about nattokinase. Here is a research paper that you can study along with reading the papers that are referenced at the bottom of the study. It’s called “A single-dose of oral nattokinase potentiates thrombolysis and anti-coagulation profiles.
Carolyn Dean MD ND
The Doctor of the Future®
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