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Dabigatran Compared With Rivaroxaban vs Warfarin
To the Editor In a recent Original Investigation inJAMA Internal Medicine, Graham and colleagues compared outcomes among patients with nonvalvular atrial fibrillation (NVAF) treated with dabigatran or rivaroxaban. Using Medicare claims data, they found that rivaroxaban, compared with dabigatran, was associated with a trend toward less thromboembolic stroke and more intracranial and extracranial bleeding. In the accompanying Editor ’s Note, Parks and Redberg state, “The additional information should lead us to prescribe dabigatran over rivaroxaban for patients with atrial fibrillation.”(p1672) The methodological featu...
Source: JAMA Internal Medicine - May 1, 2017 Category: Internal Medicine Source Type: research

Dabigatran vs Rivaroxaban for Nonvalvular Atrial Fibrillation
This cohort study compares risks of thromboembolic stroke, intracranial hemorrhage, major extracranial bleeding, and mortality in Medicare beneficiaries with nonvalvular atrial fibrillation who initiated dabigatran or rivaroxaban therapy for stroke prevention.
Source: JAMA Internal Medicine - November 1, 2016 Category: Internal Medicine Source Type: research

Vitamin K and non-vitamin K antagonists oral anticoagulants for non-valvular atrial fibrillation in real-life.
CONCLUSION: Patients given rivaroxaban and apixaban in clinical practice have a higher thrombotic and hemorrhagic risk in comparison with patients given dabigatran or VKAs. A considerable proportion of patients receive reduced doses of NOACs. PMID: 27394924 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - July 5, 2016 Category: Internal Medicine Authors: Giustozzi M, Vedovati MC, Verdecchia P, Pierpaoli L, Verso M, Conti S, Cianella F, Marchesini E, Filippucci E, Agnelli G, Becattini C Tags: Eur J Intern Med Source Type: research

Use of non‐vitamin K antagonist oral anticoagulants in atrial fibrillation patients: insights from a specialist atrial fibrillation clinic
ConclusionIn this specialist AF clinic, patients prescribed NOACs had a favourable adverse event profile with good efficacy for stroke prevention, with a low rate of cessation or switch to warfarin.
Source: International Journal of Clinical Practice - August 3, 2015 Category: Internal Medicine Authors: S. I. Lee, M. Sayers, G. Y. H. Lip, D. A. Lane Tags: Original Paper Source Type: research

Patient Characteristics and Risk of Bleeding With Dabigatran
To the Editor We appreciate the interesting study by Hernandez et al on the risk of bleeding with dabigatran in patients with atrial fibrillation. These are important data to an ongoing controversy. However, we would appreciate an author comment regarding the external validity of the study. To what extent is this sample of Medicare beneficiaries representative of the general population of patients with atrial fibrillation? Comparing the characteristics of patients in the RE-LY Study and the Danish population-based study, it seems that these are not effortlessly comparable. In the study by Hernandez et al, patients are cons...
Source: JAMA Internal Medicine - July 1, 2015 Category: Internal Medicine Source Type: research

Feasibility and safety of uninterrupted dabigatran therapy in patients undergoing ablation for atrial fibrillation.
Conclusion Uninterrupted dabigatran therapy in CA for AF thus may be a safe and effective anticoagulant therapy, and appears to be closely similar to continuous warfarin; however, it is essential to pay close attention to the APTT values when using dabigatran during CA. PMID: 25986252 [PubMed - in process]
Source: Internal Medicine - June 3, 2015 Category: Internal Medicine Tags: Intern Med Source Type: research

Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin
Commentary on: Larsen TB, Rasmussen LH, Gorst-Rasmussen A, et al. Dabigatran and warfarin for secondary prevention of stroke in atrial fibrillation patients: a nationwide cohort study. Am J Med 2014;127:1172–8 . Context Randomised trials have shown that patients with atrial fibrillation (AF) who are treated with a non-vitamin K antagonist oral anticoagulant (NOAC), compared with warfarin, have similar or lower rates of stroke and major bleeding, markedly reduced rates of intracranial bleeding and a consistent pattern of reduced mortality.1 Dabigatran 150 mg two times a day is the only NOAC that can significantly...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Eikelboom, J. W., Bosch, J. Tags: Epidemiologic studies, Time-to-event methods, Drugs: cardiovascular system, Stroke, Arrhythmias Aetiology/Harm Source Type: research

Evidence suggests dabigatran is an effective and safe treatment for patients with VTE requiring early parenteral therapy
Commentary on: Schulman S, Kakkar AK, Goldhaber SZ, et al.. Treatment of acute venous thromboembolism with dabigatran or warfarin and pooled analysis. Circulation 2014;129:764–72. Context Until recently, an initial course of parenteral anticoagulation followed by vitamin K antagonist (VKA) was the standard of care for the treatment of venous thromboembolism (VTE). In the past few years, direct oral anticoagulants (DOAC) have been found to be non-inferior to VKA.1–3 The RE-COVER study found dabigatran to be non-inferior to warfarin, with a reduced risk for clinically relevant bleeding.4 In order to confirm these...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Granziera, S., Cohen, A. T. Tags: Drugs: cardiovascular system, Stroke, Venous thromboembolism, Radiology, Pulmonary embolism, Clinical diagnostic tests Therapeutics Source Type: research

Controversies regarding the new oral anticoagulants for stroke prevention in patients with atrial fibrillation
This article raises 10 controversial issues regarding the use of NOACs for stroke prevention in patients with atrial fibrillation, and offers a review of the latest available evidence. We provide a brief overview of the mechanism and dosing of these drugs, as well as a summary of the key clinical trials that have brought them into the spotlight. Comparative considerations relative to warfarin such as NOAC safety, efficacy, bleeding risk, reversibility, drug-transitioning and use in patients well controlled on warfarin are addressed. Use in select populations such as the elderly, those with coronary disease, renal impairmen...
Source: Vascular Medicine recent issues - May 30, 2014 Category: Internal Medicine Authors: Mohanty, B. D., Looser, P. M., Gokanapudy, L. R., Handa, R., Mohanty, S., Choi, S. S., Goldman, M. E., Fuster, V., Halperin, J. L. Tags: Review Articles Source Type: research

Dabigatran increased bleeding and stroke compared with warfarin after mechanical heart valve implantation.
PMID: 24343411 [PubMed - in process]
Source: Annals of Internal Medicine - December 17, 2013 Category: Internal Medicine Authors: Kolias TJ Tags: Ann Intern Med Source Type: research

A Review of Oral Anticoagulants in Patients with Atrial Fibrillation
Arnold J. Greenspon, MD DOI: 10.3810/pgm.2012.11.2608 Abstract: There is a high prevalence of atrial fibrillation in the United States, particularly in the elderly population. Patients with atrial fibrillation are at an increased risk of stroke and anticoagulant therapy is recommended. However, many eligible patients are not receiving therapy due to limitations and concerns related to the use of the vitamin K antagonist warfarin, such as slow onset of action, variable drug metabolism, risk of bleeding, and requirement for monitoring. Novel oral anticoagulants (NOACs) have been developed and may be used as an alternat...
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

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