What question did this study set out to answer?

This study aims to evaluate the effectiveness and safety of apixaban compared to warfarin in non-valvular atrial fibrillation patients in a real-world setting.

March 16, 2017Thrombosis and HaemostasisOpen Access

Effectiveness and safety of apixaban versus warfarin in non-valvular atrial fibrillation patients in “real-world” clinical practice

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Why the study?

Does apixaban reduce the risk of stroke/systemic embolism and major bleeding compared to warfarin in real-world patients with non-valvular atrial fibrillation?

Population

76,940 patients with non-valvular atrial fibrillation newly initiating apixaban or warfarin, mean age 71…

Comparison

Apixaban (standard- and low-dose regimens) vs Warfarin (1:1 propensity score matched)

Design

Cohort

Follow-up

within one year of therapy initiation

Authors

XLXiaoyan LiNanchang University SDSteve DeitelzweigOchsner Medical Center AKAllison KeshishianPreventive Cardiology

Discussion

Member takes

Implication

Supports apixaban preference in real-world NVAF; extends low-certainty evidence but leaves practice change open.

Key Points

This study aims to evaluate the effectiveness and safety of apixaban compared to warfarin in non-valvular atrial fibrillation patients in a real-world setting.
Retrospective analysis using four large US claims databases with newly initiating apixaban or warfarin patients.
Propensity score matching (1:1) was conducted for 76,940 patients to balance baseline characteristics.
Cox proportional hazards models and Kaplan-Meier curves estimated risks of stroke/systemic embolism and major bleeding.
Apixaban initiation was associated with a lower risk of stroke/systemic embolism (HR: 0.67, 95% CI: 0.59-0.76).
Apixaban users had a significantly lower risk of major bleeding (HR: 0.60, 95% CI: 0.54-0.65) than warfarin users.
These findings were consistent across various high-risk subgroups and different dosing regimens of apixaban.

Structured PICO

Does apixaban reduce the risk of stroke/systemic embolism and major bleeding compared to warfarin in real-world patients with non-valvular atrial fibrillation?

Population

76,940 patients with non-valvular atrial fibrillation (NVAF) newly initiating apixaban or warfarin, mean age 71 years, mean CHA2DS2-VASc score 3.2, from four large US claims databases.

Intervention

Apixaban (standard- and low-dose regimens)

Comparator

Warfarin (1:1 propensity score matched)

Outcome

Cumulative incidence of stroke/systemic embolism (SE) and major bleeding within one year of therapy initiationhard clinical

In a large real-world US cohort of patients with non-valvular atrial fibrillation, apixaban was associated with significantly lower risks of stroke, systemic embolism, and major bleeding compared to warfarin.

Cite This Study

Li et al. (2017) studied this question.

synapsesocial.com/papers/69cd9897ee48e5fa6293c3b0 https://doi.org/10.1160/th17-01-0068

Topics

Atrial fibrillation Anticoagulation in AF Persistent AF management

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Effectiveness and safety of apixaban versus warfarin in non-valvular atrial fibrillation patients in “real-world” clinical practice

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Effectiveness and safety of apixaban versus warfarin in non-valvular atrial fibrillation patients in “real-world” clinical practice

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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