Direct-Acting Oral Anticoagulants vs. Warfarin in “Real-World” Patients

Although apixaban, compared with warfarin, was associated with lower risk for major bleeding, low-dose apixaban was associated with higher risk for death.

Randomized trials have established the noninferiority of direct-acting oral anticoagulants (DOACs) compared with warfarin in patients with atrial fibrillation (AF). However, little is known about how these drugs compare in “real-world” patients, especially patients without AF. U.K. investigators used general practice databases and compared risks for bleeding, stroke, venous thromboembolism, and mortality among nearly 200,000 patients (about half with AF) who received first prescriptions for dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), and warfarin between 2011 and 2016.

In patients with AF, the following statistically significant differences (for DOAC use, compared with warfarin use) were noted for bleeding and mortality:…

Reviewing Author

Paul S. Mueller, MD, MPH, FACP

Disclosures

Nothing to disclose

Paul S. Mueller, MD, MPH, FACP

Disclosures

Nothing to disclose

Direct-Acting Oral Anticoagulants vs. Warfarin in “Real-World” Patients

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Reviewing Author