scholarly journals THE EFFICACY AND SAFETY OF NEW ORAL ANTICOAGULANTS IN PATIENTS WITH ATRIAL FIBRILLATION IN CLINICAL PRACTICE

2016 ◽  
Vol 12 (2) ◽  
pp. 220-226 ◽  
Author(s):  
S. V. Moiseev
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Oral Anticoagulants ◽  
New Oral Anticoagulants ◽  
Efficacy And Safety

Indirect Comparisons of the New Oral Anticoagulants in Patients with Non-Valvular Atrial Fibrillation

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4363-4363 ◽  
Author(s):  
Shabnam Zolfaghari ◽  
Job Harenberg ◽  
Svetlana Marx ◽  
Martin Wehling
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Conflicts Of Interest ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
New Oral Anticoagulants ◽  
Efficacy And Safety ◽  
Systemic Embolism ◽  
Indirect Comparisons

Abstract Abstract 4363 The efficacy and safety of new oral anticoagulants has been demonstrated for prevention of ischemic stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF) by dabigatran in the RE-LY trial (150mg and 110mg bid), rivaroxaban in the ROCKET AF trial (20mg od), and apixaban in the ARISTOTLE trial (5mg bid) versus INR-adjusted warfarin. Direct comparisons of the NOACs in this indication are unlikely to be performed. A total of 4 indirect comparisons of these trials on the efficacy and safety of NOACs in patients with NVAF have now been published within only 3 months (Lip et al 2012, Harenberg et al 2012, Mantha et al 2012, Wells et al 2012). Here, we compare the results of these 4 network meta-analysis (NMA). In all 4 NMAs of the 3 new oral anticoagulants dabigatran (150mg bid) showed superior efficacy in preventing ischemic stroke plus systemic embolism to dabigatran (110mg bid, p<0.04) and rivaroxaban (p<0.04). Apixaban had equivalent efficacy with rivaroxaban and dabigatran (either dose). Apixaban was safer (less major bleeding) than dabigatran (150mg bid, p<0.04) or rivaroxaban (p<0.005). Intracerebral haemorrhage occurred with equal frequency for all agents and regimens except for rivaroxaban (higher risk than dabigatran 110mg bid, p<0.005). Myocardial infarction occurred less frequently with rivaroxaban and apixaban compared to either dose of dabigatran (all p<0.05). All-cause mortality was not different for any agent or regimen. Some minor differences between the NMAs may result from the approved doses of dabigatran by the FDA (150mg bid and 75mg bid) and EMA (150mg bid and 110mg bid), as the inclusion of the 110 mg bid dose of dabigatran into the NMA may not be seen relevant in the US. Based on this comparison, doctors and patients have to decide which suggestions of the 4 groups of authors seem more convincing: to change to or to start with one of the NOACs depending on the individual thrombotic or bleeding risk or to wait for the results from a large (and expensive) head-to-head randomised controlled trial which may take years to perform. Disclosures: No relevant conflicts of interest to declare.

New anticoagulants in clinical practice. Effectiveness and problems

2016 ◽  
Vol 94 (5) ◽  
pp. 383-387
Author(s):  
Igor N. Bokarev ◽  
T. B. Kondrat’eva
Keyword(s):  
Atrial Fibrillation ◽  
Acute Coronary Syndrome ◽  
Clinical Practice ◽  
Oral Anticoagulants ◽  
New Oral Anticoagulants ◽  
Coronary Syndrome ◽  
New Anticoagulants ◽  
Antivitamins K

We analyze the effectiveness of new oral anticoagulants and antivitamins K for the treatment of patients with venous problems, atrial fibrillation, and acute coronary syndrome with reference to advantages of this therapy and methods of prevention of complications of these conditions.

Experience in Daily Clinical Practice of Ambulatory Cardioversion of Atrial Fibrillation Treated With New Oral Anticoagulants

2014 ◽  
Vol 67 (11) ◽  
pp. 960-961
Author(s):  
Enrique Santas ◽  
José Méndez ◽  
Ángel Martínez-Brotons ◽  
Julio Núñez ◽  
Francisco Javier Chorro ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Oral Anticoagulants ◽  
Daily Clinical Practice ◽  
New Oral Anticoagulants

scholarly journals Efficacy and safety of the target-specific oral anticoagulants for stroke prevention in atrial fibrillation: the real-life evidence

2016 ◽  
Vol 8 (2) ◽  
pp. 67-75 ◽  
Author(s):  
Vincenzo Russo ◽  
Anna Rago ◽  
Riccardo Proietti ◽  
Federica Di Meo ◽  
Andrea Antonio Papa ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Real World ◽  
Stroke Prevention ◽  
Oral Anticoagulants ◽  
Efficacy And Safety ◽  
Thromboembolic Stroke ◽  
The Real ◽  
Concise Review ◽  
Real World Setting

The aim of our article is to provide a concise review for clinicians entailing the main studies that evaluated the efficacy and safety of target-specific oral anticoagulants (TSOAs) for thromboembolic stroke prevention in the real-world setting. Atrial fibrillation (AF) is one of the most common supraventricular arrhythmias that requires anticoagulation therapy to prevent stroke and systemic embolism. TSOAs, dabigatran, apixaban and rivaroxaban have become available as an alternative to warfarin anticoagulation in nonvalvular atrial fibrillation (NVAF). Randomized clinical trials showed non-inferior or superior results in efficacy and safety of the TSOAs compared with warfarin for stroke prevention in NVAF patients. For this reason, the 2012 update to the European Society of Cardiology guidelines for the management of AF recommends TSOAs as broadly preferable to vitamin K antagonists (VKAs) in the vast majority of patients with NVAF [Camm et al. 2012]. Although the clinical trial results and the guideline’s indications, there is a need for safety and efficacy data from unselected patients in everyday clinical practice. Recently, a large number of studies testing the efficacy and the safety of TSOAs in clinical practice have been published. The aim of our article is to provide a concise review for clinicians, outlining the main studies that evaluated the efficacy and safety of TSOAs for thromboembolic stroke prevention in the real-world setting.

scholarly journals Clinical efficacy and safety of direct oral anticoagulants in patients with atrial fibrillation in real-world clinical practice

2021 ◽  
Vol 5 (4) ◽  
pp. 196-199
Author(s):  
M.V. Khruslov ◽  
◽  
A.S. Sorokina ◽  
Yu.A. Sapel'nikova ◽  
T.V. Vavilova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Clinical Efficacy ◽  
Real World ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Bleeding Complications ◽  
Efficacy And Safety ◽  
Daily Group ◽  
Thrombotic Complications

Aim: to assess the efficacy and safety of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AFib) in real-world clinical practice. Patients and Methods: this non-interventional prospective study enrolled 356 patients aged 50-75 years with AFib and creatinine clearance ≥50 ml/min. All patients were divided into three age-matched groups based on DOACs prescribed. Group 1 patients (n=120) received rivaroxaban 20 mg daily. Group 2 patients (n=112) received dabigatran etexilate 150 mg twice daily. Group 3 patients (n=124) received apixaban 5 mg twice daily. The groups were comparable in comorbidities and the risks of thrombotic and hemorrhagic complications. Followup was 2 years after starting treatment. Thrombotic complications, massive bleedings, and death for any reason were considered end-points. Results: no significant differences in the rate of cardiogenic thrombotic complications between the groups were reported. In patients who received apixaban, fewer bleeding complications were diagnosed (insignificant differences). Conclusions: the efficacy and safety of DOACs in patients over 50 years are similar. KEYWORDS: atrial fibrillation, oral anticoagulants, thrombotic complications, infarction, stroke, bleedings. FOR CITATION: Khruslov M.V., Sorokina A.S., Sapel'nikova Yu.A., Vavilova T.V. Clinical efficacy and safety of direct oral anticoagulants in patients with atrial fibrillation in real-world clinical practice. Russian Medical Inquiry. 2021;5(4):196–199 (in Russ.). DOI: 10.32364/2587-6821-2021-5-4-196-199.

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