The Duke Clinical Research Institute in Durham, North Carolina performed a study of 14,000 patients and found that a new once-a-day pill called Rivaroxaban prevents strokes as effectively as the current treatment of Coumadin.  The median age of the patients involved in the clinical trial was 73 years old and often had other co-morbidities. 

The medication Coumadin inhibits blood clotting and is often used for the treatment of atrial fibrillation however there is a major risk for bleeding.  In 2006 the FDA requested that the makers of Coumadin notify consumers of the bleeding risk with a black box warning (FDA’s strongest safety alert). 

The new drug (Rivaroxaban) does not require routine blood testing to monitor the ability of the patient’s blood to clot and avoids unwanted bleeding.  The medication is not yet available and is expected to be expensive however this study shows promise that there may be safer alternatives for managing atrial fibrillation in our frail, elderly population.