Covid’s Deadly Clotting Spurs U.S. Trials of Blood Thinners

(Bloomberg) -- U.S. researchers have begun two clinical trials examining the use of blood thinners to help Covid-19 patients avoid clotting that’s led to strokes, heart attacks and organ failure.

In one study, the National Institutes of Health will look at the use of apixaban in people who haven’t been hospitalized, according to a statement from the NIH. Apixaban is sold under the brand name Eliquis by Bristol Myers Squibb Co. and Pfizer Inc., with the first generic versions approved last year. The other trial will study the use of heparin in patients who are hospitalized.

Clotting incidents are “strikingly more prevalent” in Covid-19 patients in intensive care, with about 20% to 30% experiencing the problem, said Gary Gibbons, Director of the NIH’s Heart, Lung, and Blood Institute, which will lead the trials. Other intensive-care patients have clotting about 5% to 10% of the time, he said.

Gibbons said he expects to have answers from the trial in “months not years.”

Doctors noticed the clotting concerns early in the pandemic and have been using blood thinners in various ways to help patients, NIH Director Francis Collins said on a call with reporters. The trials will help doctors “have a clear sense of what is the most beneficial way,” he said.

The link between Covid-19 and clotting appears to be with the endothelial cells that line the body’s blood vessels. These cells contain a protein that the novel coronavirus attaches to as it infects the body, including the lungs, heart and other organs, Gibbons explained in June.

Hospitalized patients will receive either low or high doses of heparin while those being treated outside of a hospital will get either apixaban, aspirin, or a placebo.

Eliquis was Bristol-Myers’ best-selling drug last year even before the pandemic hit the U.S. It generated $7.9 billion in revenue last year, according to data compiled by Bloomberg. Pfizer generated $4.2 billion from Eliquis last year.

Researchers will also look for common genetic traits among those who aren’t hospitalized that then develop complications

Researchers previously assessed the records of more than 2,700 Covid-19 patients hospitalized at Mount Sinai Health System and found signs anticoagulants may help improve survival, according to a June paper published in the Journal of the American College of Cardiology.

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