Are All DOACs Created Equal for Managing Atrial Fibrillation?

For efficacy — yes; for safety, apixaban is associated with somewhat less gastrointestinal bleeding.

Although randomized trials have shown that all four available direct-acting oral anticoagulants (DOACs; apixaban, dabigatran, edoxaban, and rivaroxaban) prevent thromboembolic complications related to atrial fibrillation, less evidence is available to guide which DOAC to select. In a retrospective study, investigators accessed five electronic health databases from Europe and the U.S. to compare >500,000 new DOAC users with newly diagnosed atrial fibrillation. Follow up varied from 1.5 to 4.5 years.

In propensity score–adjusted analyses, patients who received apixaban had significantly less gastrointestinal (GI) bleeding did those who received any of the other three drugs (hazard ratios, 0.7–0.8). This result was consistent among older patien…

Reviewing Author

Daniel D. Dressler, MD, MSc, MHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Daniel D. Dressler, MD, MSc, MHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Are All DOACs Created Equal for Managing Atrial Fibrillation?

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Reviewing Author