A Comparison of DOACs Using Real-World Data

Apixaban treatment was associated with fewer major ischemic or intracranial hemorrhagic events compared with rivaroxaban in patients with atrial fibrillation.

Four direct-acting oral anticoagulants (DOACs) are now approved in the U.S. for stroke prevention in atrial fibrillation. They have all been compared with warfarin in randomized, controlled trials (RCTs), but not against each other in any randomized trial, and this is unlikely to happen. Thus, retrospective comparison data are likely all we will have to guide DOAC choice in this setting.

In a retrospective cohort study of U.S. Medicare beneficiaries, investigators compared outcomes with rivaroxaban versus apixaban treatment in 581,451 patients with atrial fibrillation (mean age, 77 years). These are the two DOACs predominantly used in the U.S. for this indication.

During follow-up of up to 4 years (median, ≈6 months), the primary composite en…

Reviewing Author

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

A Comparison of DOACs Using Real-World Data

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Reviewing Author