Effectiveness and Safety of Apixaban Compared With Rivaroxaban for Patients With Atrial Fibrillation in Routine Practice: A Cohort Study

Annals of Internal Medicine
Michael FralickJoshua J Gagne

Abstract

Apixaban and rivaroxaban are the most commonly prescribed direct oral anticoagulants for adults with atrial fibrillation, but head-to-head data comparing their safety and effectiveness are lacking. To compare the safety and effectiveness of apixaban versus rivaroxaban for patients with nonvalvular atrial fibrillation. New-user, active-comparator, retrospective cohort study. A U.S. nationwide commercial health care claims database from 28 December 2012 to 1 January 2019. Adults newly prescribed apixaban (n = 59 172) or rivaroxaban (n = 40 706). The primary effectiveness outcome was a composite of ischemic stroke or systemic embolism. The primary safety outcome was a composite of intracranial hemorrhage or gastrointestinal bleeding. 39 351 patients newly prescribed apixaban were propensity score matched to 39 351 patients newly prescribed rivaroxaban. Mean age was 69 years, 40% of patients were women, and mean follow-up was 288 days for new apixaban users and 291 days for new rivaroxaban users. The incidence rate of ischemic stroke or systemic embolism was 6.6 per 1000 person-years for adults prescribed apixaban compared with 8.0 per 1000 person-years for those prescribed rivaroxaban (hazard ratio [HR], 0.82 [95% CI, 0.68 to 0.98...Continue Reading

References

Jun 13, 2001·JAMA : the Journal of the American Medical Association·B F GageM J Radford
Jul 16, 2005·Stroke; a Journal of Cerebral Circulation·Rae A Kokotailo, Michael D Hill
Oct 4, 2008·Drug Metabolism and Disposition : the Biological Fate of Chemicals·Nirmala RaghavanDonglu Zhang
Aug 13, 2011·The New England Journal of Medicine·Manesh R PatelUNKNOWN ROCKET AF Investigators
Aug 30, 2011·The New England Journal of Medicine·Christopher B GrangerUNKNOWN ARISTOTLE Committees and Investigators
Jan 25, 2012·Pharmacoepidemiology and Drug Safety·Paul N JensenSascha Dublin
Feb 1, 2012·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·A John CammUNKNOWN Scene 2 Investigators
Jul 13, 2012·Circulation. Cardiovascular Quality and Outcomes·Sebastian SchneeweissJerry Avorn
Nov 28, 2012·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Tara GomesDavid N Juurlink
Jul 23, 2013·Journal of the American Heart Association·Emil L FosbolUNKNOWN ORBIT-AF Investigators and Patients
Aug 2, 2013·The International Journal of Biostatistics·Liang Li, Tom Greene
Dec 19, 2013·Circulation·Sumeet S ChughChristopher J L Murray
Jul 31, 2014·Epidemiology·Shirley V WangJeremy A Rassen
Nov 25, 2014·Clinical Pharmacology : Advances and Applications·Charles FrostFrank LaCreta
Apr 26, 2015·Circulation·Emma SvennbergMårten Rosenqvist
May 20, 2015·Thrombosis Research·D M Adcock, R Gosselin
Jul 7, 2015·The American Journal of Medicine·Geoffrey D BarnesZachary D Goldberger
Jul 15, 2016·Journal of the American Heart Association·Xiaoxi YaoPeter A Noseworthy
Sep 10, 2016·The Canadian Journal of Cardiology·Laurent MacleUNKNOWN CCS Atrial Fibrillation Guidelines Committee
Jul 12, 2017·Annals of Internal Medicine·Tyler J VanderWeele, Peng Ding
Nov 10, 2017·European Journal of Gastroenterology & Hepatology·Anna LicataPiero L Almasio
Jul 6, 2018·BMJ : British Medical Journal·Yana VinogradovaJulia Hippisley-Cox
Dec 21, 2018·Stroke; a Journal of Cerebral Circulation·Gregory Y H LipSteven Deitelzweig

❮ Previous
Next ❯

Citations

Jul 7, 2020·British Journal of Clinical Pharmacology·Patrick C SouvereinHelga Gardarsdottir
Aug 31, 2020·F1000Research·J David Spence
May 14, 2020·Journal of Clinical Medicine·Larisa AnghelCristian Stătescu
Mar 6, 2021·Naunyn-Schmiedeberg's Archives of Pharmacology·Alfredo Jose Pardo-CabelloJuan de Dios Luna
Apr 26, 2020·Cardiology in Review·Filipe FerrariRicardo Stein
Jul 1, 2021·Journal of Veterinary Cardiology : the Official Journal of the European Society of Veterinary Cardiology·A L GagnonE C Orton
Aug 23, 2021·European Journal of Internal Medicine·Wen-Yi HuangMeng Lee
Aug 6, 2021·British Journal of Clinical Pharmacology·Adane Teshome KefaleLuke R Bereznicki

❮ Previous
Next ❯

Software Mentioned

Optum
R
Aetion Evidence Platform

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.