Key result
Direct oral anticoagulants, particularly apixaban, were more effective and safer than warfarin for stroke prevention in atrial fibrillation, significantly reducing all-cause mortality (OR 0.88).
Why the study?
This overview was commissioned by England's DHSC to assess evidence on direct OACs versus usual care in adults for stroke prevention in AF and VTE prevention and treatment.
Do direct oral anticoagulants, genotyping, self-monitoring, and pharmacist management improve efficacy, safety, and adherence compared to usual care in adults with AF or VTE?
Population
49 systematic reviews of adults requiring anticoagulation for AF or VTE
Comparison
Direct OACs vs usual care
Design
Systematic overview of systematic reviews
Authors
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Supports preferring apixaban over warfarin for AF stroke prevention; reinforces mortality benefit from prior randomized trials.
Systematic Review (n=49)
Do direct oral anticoagulants, genotyping, self-monitoring, and pharmacist management improve efficacy, safety, and adherence compared to usual care in adults with AF or VTE?
Odds Ratio: 0.88 (95% CI 0.79–0.98)
Direct oral anticoagulants, particularly apixaban, offer superior efficacy and safety for stroke prevention in atrial fibrillation compared to warfarin, while education and pharmacist management improve coagulation control.
Khouja et al. (2022) conducted a systematic review in Atrial fibrillation and venous thromboembolism (n=49). Direct oral anticoagulants vs. Warfarin or usual care was evaluated on All-cause mortality (in atrial fibrillation patients) (OR 0.88, 95% CI 0.79-0.98). Direct oral anticoagulants, particularly apixaban, were more effective and safer than warfarin for stroke prevention in atrial fibrillation, significantly reducing all-cause mortality (OR 0.88).
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