Apixaban Dosing: Questions Linger

Patients with atrial fibrillation (AF) and their clinicians have several choices of anticoagulants for the prevention of stroke. We are still clarifying issues of dosing in apixaban, a direct factor Xa inhibitor. These researchers reanalyzed findings from ARISTOTLE, a randomized double-blind comparison of apixaban and warfarin in 18,201 patients with AF and at least one other risk factor for stroke. The overall results favored apixaban at the median follow-up of 1.8 years.

In the study, a reduced dose (2.5 mg twice daily instead of 5.0 mg twice daily) was used for people who met at least two of the following criteria: age ≥80, weight ≤60 kg, and creatinine ≥1.5 mg/dL. People meeting only one criterion received the twice-daily 5.0-mg dose. Th…