Physicians and medical scientists have the opinion that the available and cost effective treatment called apixaban, an anticoagulant, can help save the lives of critically ill coronavirus infected patients without any side effects.
Bangladeshi medical experts say this injectable anticoagulant treatment, combined with other medicines, is a breakthrough in the fight against the deadly virus.
Mostly Covid-19 patients in critical condition face the risk of blood clotting in their organs, which may result in death. So, using apixaban to reduce blood clotting might ultimately reduce the risk of death from Covid-19.
However, this drug should only be used in critical patients and under the monitoring of a doctor.
Dhaka Medical College Hospital (DMCH) Director Brig Gen AKM Nasir Uddin said, using this medicine can reduce the risk of death in patients on ventilators and those who are being treated with oxygen.
“Generally the patients who are in severe and critical condition are admitted at DMCH. We are providing this treatment to 80% of the critical patients at DMCH.”
Till now, around 700 Covid-19 patients have received this treatment at DMCH.
“We are providing this treatment under the National Guidelines on Clinical Management of Coronavirus Disease 2019 and national treatment protocol,” said Dr AKM Nasir Uddin.
Despite this treatment being at the study level it is bringing tremendous success in the treatment of coronavirus patients.
Prime Minister Sheikh Hasina's personal physician Dr ABM Abdullah said: “Apixaban is used to stop blood clots and keep blood circulation normal. This treatment is given to patients who have suffered from strokes, heart diseases, diabetics, and other diseases which may cause blood clots.”
However, the professor of medicine warned: “No one can give this treatment personally at home. It is mandatory to be admitted in the hospital and monitored by the doctor. A doctor can administer the injectable form of the medicine after the patient is hospitalized. After five or seven days they can be given apixaban tablet.”
Dr Mujibur Rahman, head of the Department of Medicine at DMC, said: “If blood clots form in the brain, lungs or any other part of the body, it is not advisable to give any kind of treatment without hospitalization.”
A study found that many patients in the US and other countries are being treated for blood clots using this medicine in hospitals, he added.
“We are using the same treatment procedure as the other countries in the world, but in our country, there is no study or statistics on the number of patients suffering from blood clotting. We are practicing this treatment following international studies and journals,” said Prof Dr Mujibur Rahman.
He also mentioned that those who are infected with Covid-19 might suffer from pneumonia, and pneumonia increases the risk of blood clotting. Using this medicine is bearing positive results.
What is apixaban?
Apixaban is an anticoagulant (blood thinner) that reduces blood clotting and reduces the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (Afib or AF).
In December of 2019, the US Food and Drug Administration (FDA) approved two applications for the first generics of the anticoagulant (apixaban) in the name of Eliquis tablets.
How it works
Apixaban works by preventing the patient's blood from clotting as quickly or as effectively as possible. It does this by blocking the substance involved in the development of blood clots.
This treatment needs to be stopped as soon as the patient's blood circulation, lungs, and other organ functions start functioning normally.
Side effects of apixaban
DMCH Director Brig Gen AKM Nasir Uddin said so far the researcher did not find any significant side effects of this medicine.
AKM Nasir Uddin says the patient should be given this medicine in the hospital if needed. However, he warned that no one should buy these medicines from the market and store them at home.
While other treatments including plasma therapy, hydroxychloroquine, dexamethasone, remdesivir, doxycycline and other treatment for Covid-19 has shown side effects but apixaban is still working without any side effects and ineffectiveness worldwide, said AKM Nasir Uddin.
There was no clinical trial but the use of apixaban in Covid-19 treatment has already begun in elder patients or on those in the ICU since it was found that it accelerated their recovery.
Trials of other drugs for the treatment of Covid-19 have been going on in Bangladesh since March.
The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) and Institute of Epidemiology Disease Control And Research (IEDCR) are conducting clinical trials after a team of physicians of Bangladesh Medical College (BMC) led by Prof Dr Tarek Alam claimed that a combination of an anti-parasitic drug, ivermectin, along with antibiotic doxycycline has yielded tremendous success in treating Covid-19 infection.
