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January 1, 2014Thrombosis and Haemostasis

Efficacy and safety of edoxaban in comparison with dabigatran, rivaroxaban and apixaban for stroke prevention in atrial fibrillation

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Why the study?

Does edoxaban improve efficacy and safety compared to apixaban, dabigatran, and rivaroxaban in patients with atrial fibrillation?

Population

Patients with atrial fibrillation (AF) requiring stroke prevention

Comparison

Edoxaban vs Apixaban, dabigatran etexilate, and rivaroxaban

Design

Meta-analysis

Authors

TLTorben Bjerregaard LarsenLRLars Hvilsted RasmussenGLGregory Y.H. Lip

Discussion

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Overview

Apixaban may reduce bleeding versus high-dose edoxaban in AF; extends indirect comparisons but leaves direct RCTs open.

Structured PICO

Does edoxaban improve efficacy and safety compared to apixaban, dabigatran, and rivaroxaban in patients with atrial fibrillation?

P
Population
Patients with atrial fibrillation (AF) requiring stroke prevention
I
Intervention
Edoxaban (2 dose strategies: high-dose and low-dose)
C
Comparator
Apixaban (1 dose), dabigatran etexilate (110 mg twice daily and 150 mg twice daily), and rivaroxaban (1 dose)
O
Outcome
Efficacy endpoints (stroke/systemic embolism, stroke, ischaemic stroke, haemorrhagic stroke, mortality, myocardial infarction) and safety endpoints (major bleeding, clinically relevant non-major bleeding, gastrointestinal bleeding)hard clinical

Indirect comparisons of NOACs for stroke prevention in AF reveal differential efficacy and bleeding risks, supporting individualized anticoagulant selection based on patient clinical profiles.

Limitations

  • significant limitations of an indirect comparison analysis

Cite This Study

Larsen et al. (2014) studied this question.

synapsesocial.com/papers/6a71fa74b27f15817827e64bhttps://doi.org/10.1160/th14-02-0118
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effect of edoxaban compared with other oral anticoagulants for stroke prevention in patients with atrial fibrillation: A meta-analysis2023 · 16 citations
  2. 2Comparative Clinical Outcomes of Edoxaban in Adults With Nonvalvular Atrial Fibrillation2018 · 2 citations
  3. 3Edoxaban in the Evolving Scenario of Non Vitamin K Antagonist Oral Anticoagulants Imputed Placebo Analysis and Multiple Treatment Comparisons2014 · 29 citations
  4. 4Primary and secondary prevention with new oral anticoagulant drugs for stroke prevention in atrial fibrillation: indirect comparison analysis2012 · 122 citations
  5. 5An indirect comparison of dabigatran, rivaroxaban and apixaban for atrial fibrillation2012 · 155 citations