Direct oral anticoagulants versus warfarin: is new always better than the old?
Why the study?
Are direct-acting oral anticoagulants (DOACs) always superior to warfarin for stroke prevention in patients with non-valvular atrial fibrillation?
Population
Patients with non-valvular atrial fibrillation (AF) requiring long-term anticoagulation for stroke prevention
Comparison
Direct-acting oral anticoagulants vs Warfarin (vitamin K antagonist)
Design
Editorial
Authors
Discussion
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Member takes
Implication
This paper challenges the universal preference for DOACs over warfarin, suggesting that genotype-guided warfarin therapy with home monitoring may be preferable and more cost-effective for many patients with non-valvular AF.
Structured PICO
Are direct-acting oral anticoagulants (DOACs) always superior to warfarin for stroke prevention in patients with non-valvular atrial fibrillation?
P
Population
Patients with non-valvular atrial fibrillation (AF) requiring long-term anticoagulation for stroke prevention
I
Intervention
Direct-acting oral anticoagulants (DOACs: dabigatran, rivaroxaban, apixaban, edoxaban)
C
Comparator
Warfarin (vitamin K antagonist)
This paper challenges the universal preference for DOACs over warfarin, suggesting that genotype-guided warfarin therapy with home monitoring may be preferable and more cost-effective for many patients with non-valvular AF.
Cite This Study
Burn et al. (2018) studied this question.