Real-world clinical evidence on rivaroxaban, dabigatran, and apixaban compared with vitamin K antagonists in patients with nonvalvular atrial fibrillation: a systematic literature review

Expert Review of Pharmacoeconomics & Outcomes Research
Jean-Baptiste BriereOlivia Wu

Abstract

Several comparative real-world effectiveness studies on direct oral anticoagulants (DOACs) have been conducted, but an overview of the available evidence remains to be developed, which could provide a better understanding of the value of DOACs relative to vitamin K antagonists (VKAs). A systematic literature review was conducted on the available real-world evidence (RWE) of three DOACs (rivaroxaban, dabigatran, and apixaban) compared with VKAs (e.g. warfarin), in patients with nonvalvular atrial fibrillation (NVAF).This systematic literature review included RWE published up to December 2016. Studies with > 50 patients reporting on incident and prevalent NVAF cases were included. The following databases were searched: Medline, Embase, and the Cochrane Library. Outcomes of interest included thromboembolic events, all-cause mortality, bleeding events, and nonpersistence. Of the 562 RWE DOACs articles retrieved, 49 presented results for rivaroxaban versus VKAs, 79 for dabigatran versus VKAs, and 18 for apixaban versus VKAs. Substantial heterogeneity was found across patient population, outcome definition, and follow-up period. Major bleeding, ischemic stroke, and intracranial hemorrhage were the most frequent outcomes analyzed. Ove...Continue Reading

References

Dec 7, 2007·The Medical Clinics of North America·William B Kannel, Emelia J Benjamin
Sep 1, 2009·The New England Journal of Medicine·Stuart J ConnollyUNKNOWN RE-LY Steering Committee and Investigators
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
Apr 9, 2013·Journal of the American College of Cardiology·Torben Bjerregaard LarsenGregory Y H Lip
May 7, 2013·BMJ Open·Rikke SørensenMorten Lock Hansen
Aug 8, 2013·Circulation. Cardiovascular Quality and Outcomes·Martin ZalesakHerman Sanchez
Feb 18, 2014·The American Journal of Medicine·Torben Bjerregaard LarsenGregory Y H Lip
Mar 22, 2014·Current Medical Research and Opinion·François LalibertéPatrick Lefebvre
Aug 12, 2014·The American Journal of Medicine·Mary S Vaughan SarrazinPeter Cram
Sep 7, 2014·The American Journal of Medicine·Torben Bjerregaard LarsenGregory Y H Lip
Nov 5, 2014·JAMA Internal Medicine·Inmaculada HernandezYuting Zhang
Sep 12, 2015·Thrombosis and Haemostasis·Meytal Avgil-TsadokL Pilote
Sep 24, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Pak-Hei ChanChung-Wah Siu
Oct 29, 2015·Circulation. Cardiovascular Quality and Outcomes·Meytal Avgil TsadokLouise Pilote
Nov 23, 2015·International Journal of Cardiology·Prasad S NishtalaSarah N Hilmer
Jan 7, 2016·Stroke; a Journal of Cerebral Circulation·Yi-Hsin ChanChi-Tai Kuo
Feb 3, 2016·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·Jan Beyer-WestendorfThomas Evers
Feb 5, 2016·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·Jennie KorenstraRobert G Tieleman
Mar 24, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Eitaro KodaniUNKNOWN J-RHYTHM Registry Investigators
Apr 18, 2016·Journal of Thrombosis and Thrombolysis·Bunyamin YavuzBurcu Balam Yavuz
Nov 3, 2016·Pharmacoepidemiology and Drug Safety·Anders Gorst-RasmussenTorben Bjerregaard Larsen
Jul 15, 2016·Journal of the American Heart Association·Xiaoxi YaoPeter A Noseworthy
Aug 28, 2016·European Heart Journal·Paulus KirchhofUNKNOWN ESC Scientific Document Group
Sep 24, 2016·Journal of the American College of Cardiology·Yi-Hsin ChanLai-Chu See
Sep 30, 2016·European Heart Journal. Cardiovascular Pharmacotherapy·Sigrun HalvorsenChristian Jonasson

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Jan 21, 2020·Expert Review of Hematology·Jennifer L KoehlRachel Rosovsky
Jul 14, 2020·Journal of Medical Economics·Kevin BowrinAurélie Millier
May 14, 2020·Journal of Clinical Medicine·Larisa AnghelCristian Stătescu

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