‘Really Great News’
Commenting on the findings for this news organization, epilepsy expert Daniel M. Goldenholz, MD, PhD, assistant professor of Neurology, Harvard Beth Israel Deaconess Medical Center, Boston, Massachusetts, said the finding of no meaningful difference between DOAC plus enzyme-inducing medications vs DOACs plus non-enzyme-inducing medications is encouraging.
“This study asks a very important question at the population level and appropriately tries to control for present and hidden factors using a propensity matching approach,” he said.
The fact that the data support no difference in terms of thromboembolic events “is really great news” for patients taking an enzyme-inducing antiseizure medication who need to use a DOAC, he said.
While some patients or clinicians might consider transitioning off an enzyme-inducing antiseizure medication, this can lead to new side effects and potentially higher drug costs. “Knowing that a transition may be unnecessary is exciting,” said Dr. Goldenholz.
However, he’s concerned the 1.5-year observation period may not be long enough to see a true effect of these drug combinations.
He also noted that due to the “theoretical higher risk,” patients combining DOACs with enzyme-inducing drugs typically need extra monitoring, which may be less practical outside the US. This suggests “the result may not necessarily generalize outside high-income countries,” he said.
Dr. Goldenholz emphasized that the data are preliminary. “As always, I look forward to a full peer-reviewed study before forming final conclusions.”
The study was supported by the US Department of Health and Human Services’ National Institute of Neurological Disorders and Stroke.
Ms. Acton and Dr. Goldenholz report no relevant financial relationships.
A version of this article appeared on Medscape.com.