Physicians' Academy for Cardiovascular Education

Direct oral anticoagulants have different gastrointestinal safety profiles

Gastrointestinal Safety of Direct Oral Anticoagulants: A Large Population-Based Study

Literature - Abraham NS, Noseworthy PA, Yao X, et al. - Gastroenterology 2017;152:1014–1022

Main results

Risk of GI bleeding with rivaroxaban vs dabigatran:

Risk of GI bleeding with apixaban vs dabigatran:

Risk of GI bleeding with apixaban vs rivaroxaban:

Apixaban had the most favourable GI safety profile compared with rivaroxaban (ARR= -2.20; 95% CI: -3.00 to -1.40; NNH = 45) and dabigatran (ARR = -1.35; 95% CI: -2.03 to -0.67; NNH = 74).

Conclusion

In a large population-based cohort of patients on DOACs due to non-valvular AF, apixaban had the most favourable GI safety profile among all age groups and rivaroxaban had the least favourable profile. These results may facilitate clinical decision making, when it comes to the selection of a DOAC for AF patients.

References

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