Methods Databases were searched for randomized warfarin-controlled trials of novel anticoagulants for non-valvular atrial fibrillation.The internal validity of included studies was high, especially given the logistical challenges involved in the conduct of a double-blind trial when warfarin is the control treatment ( Table 5 ).Conclusions Novel oral anticoagulants appear as a very promising treatment option for atrial fibrillation.
Oral anticoagulants: Comparing and contrasting the. of the new oral direct thrombin inhibitor.In a recent indirect comparison of new oral anticoagulants in patients with AF, 10 the authors.Rivaroxaban may be a less favorable choice in comparison to apixaban or dabigatran whereas it remains a valid alternative to warfarin.Adjusted indirect comparison of new oral anticoagulants for stroke prevention in atrial fibrillation.First, it has a narrow therapeutic window and requires frequent monitoring of the international normalized ratio (INR).Like apixaban, it interacts with CYP3A4 or P-glycoprotein inhibitors and inducers, and should not be used in patients with advanced liver disease.The lack of requirement for monitoring with these agents has been viewed mostly as an advantage, but it can clearly represent a disadvantage when non-compliance with therapy or overdose is suspected.Indirect comparisons of new oral anticoagulant drugs for efficacy and safety when used for stroke prevention in atrial fibrillation.Odds ratios (95% intervals) were computed with RevMan and WinBUGS.
It can also be conceived that these drugs might be cost-saving (thus proving cheaper than warfarin) in those intolerant to warfarin or failing warfarin (i.e. experiencing a thromboembolic events despite adequate INR).
Oral Anticoagulants for Stroke Prevention. new oral anticoagulants.
The primary analysis included the higher doses of dabigatran (150 mg twice daily) and edoxaban (60 mg once daily), as well as the single doses of rivaroxaban (20 mg once daily) and apixaban (5 mg twice daily).In a separate analysis that pooled results from the low-dose regimens of dabigatran (110 mg twice daily) and edoxaban (30 mg once daily), both the new anticoagulants and warfarin performed similarly for reducing stroke or systemic embolism (RR 1.03, 95% CI 0.84-1.27).
At odds with apixaban, dabigatran is not metabolized by the liver and it has no drug-to-drug interaction with CYP3A4 inhibitors or inducers, whereas it still interacts with P-glycoprotein inhibitors or inducers.The indirect comparisons of apixaban with the other oral anticoagulants dabigatran, edoxaban, and rivaroxaban, show that efficacy of apixaban in preventing thromboembolism is not statistically different from the others.Objective To summarise and compare the efficacy and safety of.
Dabigatran affects both activated partial thromboblastin and ecarin clotting times, but routine monitoring of efficacy is not indicated.Comparisons between Novel Oral Anticoagulants and Vitamin K Antagonists in Patients with CKD.However, both estimates regarding major bleeding and drug discontinuation were statistically inconsistent, suggesting different effects of the different anticoagulants.