Do new oral anticoagulants improve efficacy and safety compared to warfarin in patients with non-valvular atrial fibrillation in real clinical practice?
Real-world observational data confirms the efficacy and safety of new oral anticoagulants for stroke prevention in non-valvular atrial fibrillation, mirroring RCT findings.
New oral anticoagulants that inhibit factor Xa (rivaroxaban, apixaban, edoksaban) or thrombin (dabigatran), today are increasingly replacing warfarin and other indirect anticoagulants in preventing stroke in patients with non-valvular atrial fibrillation. They were superior to warfarin for some indicators of efficacy and safety in randomized controlled trials. However, the experience of their study in real clinical practice is limited. The need in prospective, observational studies is dictated by the fact that usual practice differs from the conditions of the randomized clinical trials that may improve the efficiency and safety of the treatment, including the expense of strict criteria for patient selection, regular visits, constant safety monitoring and etc. The results of prospective observational XANTUS study and retrospective cohort studies that shown similar results of treatment with new oral anticoagulants in randomized clinical trials and routine clinical practice are presented in the review.
Sergey Moiseev (2016) studied this question.