Why the study?
Edoxaban is widely used to prevent stroke in AF patients, but evaluating its real-world safety and effectiveness in the Brazilian clinical context is crucial.
In a real-world Brazilian cohort of patients with atrial fibrillation, routine treatment with edoxaban demonstrated low rates of cardiovascular events and major bleeding over 1 year.
Supports edoxaban continuation in Brazilian AF cohorts; extends ETNA-AF to Latin America and leaves open guideline implications.
Background Edoxaban, an orally administered anticoagulant, has been shown to be safe and effective in preventing stroke in atrial fibrillation (AF) patients. Given its widespread use since approval, evaluating edoxaban’s real-world performance in the Brazilian clinical context is crucial. Objective The study aimed to report the one-year safety and effectiveness of edoxaban in AF patients in Brazil. Methods EdoBRA is a multi-center, prospective, observational investigation conducted across 30 Brazilian research sites. Bleeding events were considered as safety measures and cardiovascular events were considered for effectiveness measures. Descriptive analyses were performed. Kaplan-Meier curves were generated for time-to-event analysis and a 95% confidence interval was used as appropriate. Results Among the 705 enrolled participants, 590 were included in the analysis for having at least one follow-up or one reported event. Mean (±SD) CHA2DS2-VASc risk score was 3 (3.3 ± 1.6) and the mean HAS-BLED risk score was 2 (1.8 ± 1.2). During the one-year follow-up period, nine major bleedings events were reported, including five cases of gastrointestinal bleeding (IP 0.85 [95% CI =0.82; 0.88]). Among the cardiovascular events recorded (N = 68), there were four stroke events (IP 0.68 [CI 95% 0.65;0.71]), one transient ischemic attack (IP 0.17 [CI 95% (0.16;0.18]) and 1 event was Venous Thromboembolic Events (IP 0.17 [CI 95% (0.16;0.18]). No systemic embolic event was exhibited by any patient. Conclusion In an elderly population with several comorbidities routinely treated with edoxaban for AF, the rates of cardiovascular event and major bleeding were low.
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Précoma et al. (2025) studied this question.
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