Stroke and bleeding risks in patients with atrial fibrillation treated with reduced apixaban dose: a real life study.

Stroke and bleeding risks in patients with atrial fibrillation treated with reduced apixaban dose: a real life study. Clin Pharmacol Ther. 2020 Jun 19;: Authors: Salameh M, Gronich N, Stein N, Kotler A, Rennert G, Auriel E, Saliba W Abstract Our objective was to assess the association between reduced apixaban dose and two outcomes: ischemic stroke/systemic embolism (SE) and major bleeding. We performed a retrospective cohort study within the database of the largest healthcare provider in Israel. We identified all patients diagnosed with atrial fibrillation, who started apixaban treatment between 2013 and 2017. Apixaban users were classified into three dosing regimen groups based on their renal function, age and weight: standard dose (5 mg bid), adjusted reduced dose (2.5 mg bid), and underdosing (2.5 mg bid). Patients were followed through 2018 for the occurrence of stroke/SE and major bleeding. Of the 27,765 included patients, 13,141 (47%) adequately received standard apixaban dose, 4,739 (17%) patients received adjusted reduced dose, and 9,885 (36%) patients were classified as underdosed. The CHA2DS2-VASc score adjusted hazard ratio for ischemic stroke/SE was 1.1 (95% CI, 0.83-1.43) in the adjusted reduced dose group, and 1.04 (95% CI, 0.83-1.35) in the underdosing group, compared to the standard apixaban dose group. The HAS-BLED score adjusted hazard ratio for any major bleeding was 1.66 (95% CI, 1.32-2.09) in the adjusted reduce...
Source: Clinical Pharmacology and Therapeutics - Category: Drugs & Pharmacology Authors: Tags: Clin Pharmacol Ther Source Type: research