Direct Oral Anticoagulants for Cancer Patients with Atrial Fibrillation

Randomized, controlled trials have shown that direct oral anticoagulants (DOAC) are as safe and effective as warfarin for the management of atrial fibrillation (AF). However, these studies have included few patients with malignancies.

Now, to evaluate the use of DOACs in patients with AF and active cancers, investigators have examined the health insurance claims of 16,096 such patients reported in a national administrative database (MarketScan) from 2010 through 2014. Patients taking the DOACs rivaroxaban (2808), dabigatran (2189), and apixaban (1078) were matched by age, sex, and dates of enrollment and anticoagulant initiation with patients taking warfarin (10,021). The primary outcome was a severe bleeding event. Secondary outcomes were o…