Edoxaban reduced the net clinical outcome compared to warfarin in most high-risk subgroups, with absolute risk reductions increasing from 0.3% to 2.0% for the higher-dose regimen.
RCT
Does edoxaban improve net clinical outcomes compared to warfarin in high-risk patients with atrial fibrillation?
Edoxaban provides greater absolute risk reductions in net clinical outcomes compared to warfarin as the number of high-risk features increases in patients with atrial fibrillation.
BACKGROUND: To compare the efficacy and safety of edoxaban vs warfarin in high-risk subgroups. METHODS: score >2 randomized to higher-dose edoxaban regimen (HDER) 60 mg/reduced 30 mg, lower-dose edoxaban regimen (LDER) 30 mg/reduced 15 mg, or warfarin, and followed for 2.8 years (median). The primary outcome for this analysis was the net clinical outcome (NCO), a composite of stroke/systemic embolism events, major bleeding, or death. Multivariable risk-stratification analysis was used to categorize patients by the number of high-risk features. RESULTS: 4+), the absolute risk reductions favoring edoxaban over warfarin increased: 0.3%->2.0% for HDER; 0.4%->3.4% for LDER vs warfarin (P = .065 and P < .001, respectively). CONCLUSIONS: While underuse of anticoagulation in high-risk patients with AF remains common, substitution of effective and safer alternatives to warfarin, such as edoxaban, represents an opportunity to improve clinical outcomes.
Gencer et al. (Mon,) conducted a rct in Atrial fibrillation. Edoxaban vs. Warfarin was evaluated on Net clinical outcome (NCO), a composite of stroke/systemic embolism events, major bleeding, or death. Edoxaban reduced the net clinical outcome compared to warfarin in most high-risk subgroups, with absolute risk reductions increasing from 0.3% to 2.0% for the higher-dose regimen.
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