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Direct comparisons ...
Direct comparisons of effectiveness and safety of treatment with Apixaban, Dabigatran and rivaroxaban in atrial fibrillation
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- Jansson, Martin (författare)
- Umeå universitet,Umeå University,Kardiologi,Umea Univ, Dept Publ Hlth & Clin Med, Sundsvall, Sweden
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- Själander, Sara, 1981- (författare)
- Umeå universitet,Umeå University,Avdelningen för medicin,Umea Univ, Dept Publ Hlth & Clin Med, Sundsvall, Sweden
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- Sjögren, Vilhelm (författare)
- Umeå universitet,Umeå University,Avdelningen för medicin,Umea Univ, Dept Publ Hlth & Clin Med, Sundsvall, Sweden
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- Renlund, Henrik, 1979- (författare)
- Uppsala universitet,Uppsala University,Uppsala kliniska forskningscentrum (UCR)
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- Norrving, B. (författare)
- Lund University,Lunds universitet,Klinisk strokeforskning,Forskargrupper vid Lunds universitet,Clinical Stroke Research Group,Lund University Research Groups,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Neurol, Dept Clin Sci Lund, Lund, Sweden
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- Själander, Anders (författare)
- Umeå universitet,Umeå University,Avdelningen för medicin,Umea Univ, Dept Publ Hlth & Clin Med, Sundsvall, Sweden
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(creator_code:org_t)
- Elsevier BV, 2020
- 2020
- Engelska 7 s.
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Ingår i: Thrombosis Research. - : Elsevier BV. - 0049-3848 .- 1879-2472. ; 185, s. 135-141
- Relaterad länk:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- Introduction: Direct oral anticoagulants (DOACs) have been proven non-inferior or superior to warfarin in preventing stroke and systemic embolism, with a lower risk of major hemorrhage, in patients with non-valvular atrial fibrillation (NVAF). We sought to investigate whether effectiveness and safety differs among apixaban, rivaroxaban and dabigatran. Materials and methods: Patients with newly initiated DOAC treatment were identified from the Swedish anticoagulation quality registry, ranging from January 1, 2013 to December 31, 2015. Patients were assigned to apixaban, dabigatran or rivaroxaban cohorts based on initiated DOAC and dose (standard or reduced). Baseline characteristics and endpoints were retrieved from validated Swedish quality registers and the National Patient Registry. Cohorts were matched using full optimal matching and directly compared. Results: A total of 25,843 NVAF patients were included. Patients treated with standard dose apixaban or dabigatran had lower risk of major bleeding than patients treated with rivaroxaban, HR 0.69 (95% CI 0.54–0.88) and HR 0.64 (95% CI 0.48–0.87). Regarding reduced dose, patients treated with apixaban had lower risk of major bleeding than those treated with dabigatran or rivaroxaban, HR 0.62 (95% CI 0.44–0.88) and HR 0.45 (95% CI 0.33–0.61). In reduced dose, patients treated with dabigatran had the lowest all-cause mortality. No differences in effectiveness were found. Conclusions: In this large real-world NVAF cohort, direct comparisons show a favorable bleeding risk profile for dabigatran and apixaban in standard dose, and for apixaban in reduced dose. No differences in effectiveness were found. This study confirms previous indirect DOAC comparisons. Further studies are needed.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmaceutiska vetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmaceutical Sciences (hsv//eng)
Nyckelord
- Anticoagulants
- Apixaban
- Atrial fibrillation
- Dabigatran
- Rivaroxaban
- Treatment outcome
- Dabigatran
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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