A systematic review of network meta-analyses among patients with nonvalvular atrial fibrillation: A comparison of efficacy and safety following treatment with direct oral anticoagulants
Key result
Apixaban matches other DOACs for stroke risk but reduces major bleeding versus rivaroxaban and dabigatran.
Why the study?
Do different direct oral anticoagulants (DOACs) differ in efficacy and safety for stroke prevention in patients with nonvalvular atrial fibrillation?
Population
Patients with nonvalvular atrial fibrillation (based on 22 included network meta-analyses)
Comparison
Direct oral anticoagulants (DOACs) vs Other DOACs
Design
Systematic_review
Authors
Discussion
Loading...
Member takes
Implication
Apixaban may be preferred for lower major bleeding risk without efficacy loss in nonvalvular AF; reinforces network meta-analysis consensus on DOAC safety.
Study Design
Type
Systematic Review
Structured PICO
Do different direct oral anticoagulants (DOACs) differ in efficacy and safety for stroke prevention in patients with nonvalvular atrial fibrillation?
P
Population
Systematic review of 22 network meta-analyses evaluating the efficacy and safety of direct oral anticoagulants in patients with nonvalvular atrial fibrillation.
I
Intervention
Direct oral anticoagulants (DOACs)
C
Comparator
Other DOACs (indirect comparisons, using apixaban as the reference)
O
Outcome
Stroke/systemic embolism and major bleedinghard clinical
This systematic review of network meta-analyses suggests that while DOACs have similar efficacy for stroke prevention in nonvalvular atrial fibrillation, apixaban is associated with a lower risk of major bleeding compared to rivaroxaban and dabigatran 150 mg.
Cite This Study
Cohen et al. (2018) conducted a systematic review in nonvalvular atrial fibrillation. Apixaban vs. Other DOACs (rivaroxaban, dabigatran 150 mg) was evaluated on Stroke/systemic embolism and major bleeding. Apixaban showed no significant difference in stroke or systemic embolism compared with other DOACs, but had a lower risk of major bleeding than rivaroxaban and dabigatran 150 mg.