Edoxaban is noninferior to warfarin for VTE management and stroke risk reduction in nonvalvular AF, though patients with creatinine clearance ≥95 mL/min had a higher rate of strokes.
Does edoxaban prevent stroke in nonvalvular AF and treat VTE compared to warfarin?
Edoxaban is a once-daily direct oral anticoagulant that is noninferior to warfarin for stroke prevention in AF and VTE treatment, though its use may be limited in patients with high creatinine clearance.
PURPOSE: The pharmacology, pharmacokinetics, pharmacodynamics, clinical efficacy, safety, and place in therapy of edoxaban for prevention of stroke in patients with nonvalvular atrial fibrillation (AF) and treatment of venous thromboembolism (VTE) are reviewed. SUMMARY: Although warfarin has been an established therapy for stroke prevention in AF and VTE, the need for agents with less monitoring requirements, fewer food and drug interactions, and a lower risk of major bleeding led to the development of direct oral anticoagulants (DOACs). Current DOACs work by either directly blocking thrombin (dabigatran) or inhibiting factor Xa (apixaban, edoxaban, and rivaroxaban). Edoxaban is the newest DOAC and only the second Food and Drug Administration-approved anticoagulant for once-daily administration. Unlike apixaban and rivaroxaban, edoxaban does not interact with the cytochrome P-450 system. The results of the ENGAGE AF-TIMI 48 and Hokusai-VTE trials demonstrated edoxaban's noninferiority to warfarin. However, the adverse-effect profile of edoxaban may limit the drug's use in clinical practice; in clinical trials, patients with AF who had a creatinine clearance of ≥95 mL/min had a higher rate of strokes with the use of edoxaban versus warfarin. CONCLUSION: A review of the literature showed that edoxaban, the most recently approved DOAC, is noninferior to warfarin for management of VTE (after parenteral anticoagulant therapy) and for stroke risk reduction in many patients with nonvalvular AF.
Poulakos et al. (Wed,) conducted a review in Nonvalvular atrial fibrillation (AF) and venous thromboembolism (VTE). Edoxaban vs. Warfarin was evaluated on Prevention of stroke in patients with nonvalvular AF and treatment of VTE. Edoxaban is noninferior to warfarin for VTE management and stroke risk reduction in nonvalvular AF, though patients with creatinine clearance ≥95 mL/min had a higher rate of strokes.
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