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Safety and efficacy of apixaban, dabigatran and rivaroxaban in obese and morbidly obese patients with heart failure and atrial fibrillation: A real ‐world analysis
ConclusionIn obese patients with congestive heart failure and atrial fibrillation or atrial flutter on DOACs, apixaban has the most favorable safety profile compared to rivaroxaban and dabigatran.
Source: Pacing and Clinical Electrophysiology : PACE - December 2, 2022 Category: Cardiology Authors: Yashasvi Chugh, Kashvi Gupta, Hanumanthu Balram Krishna, Renato Quispe Ayala, Ignacio Zepeda, Michael Grushko, Robert T Faillace Tags: ORIGINAL ARTICLE Source Type: research

Safety and Efficacy of Rivaroxaban, Apixaban, and Dabigatran in Obese and Morbidly Obese Patients with Heart Failure and Atrial Fibrillation: A Real ‐World Analysis
ConclusionIn obese patients with congestive heart failure and atrial fibrillation or atrial flutter on DOACs, apixaban has the most favorable safety profile compared to rivaroxaban and dabigatran.This article is protected by copyright. All rights reserved
Source: Pacing and Clinical Electrophysiology : PACE - November 24, 2022 Category: Cardiology Authors: Yashasvi Chugh, Kashvi Gupta, Hanumanthu Balram Krishna, Renato Quispe Ayala, Ignacio Zepeda, Michael Grushko, Robert T Faillace Tags: ORIGINAL ARTICLE Source Type: research

Effectiveness and Safety of Dabigatran in Atrial Fibrillation Patients with Severe Obesity: a Real-World Retrospective Cohort Study
ConclusionsAmong AF patients with a BMI>40kg/m2 or a weight>120kg in a real-world clinical setting, dabigatran was effective in reducing the risk of thromboembolism and mortality but was associated with an increased risk of bleeding when compared to warfarin. Dabigatran may be a reasonable option for AF patients with severe obesity.
Source: Journal of General Internal Medicine - September 20, 2021 Category: Internal Medicine Source Type: research

Pharmacokinetics of Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Extreme Obesity
Clin Ther. 2021 Aug 5:S0149-2918(21)00247-2. doi: 10.1016/j.clinthera.2021.07.003. Online ahead of print.ABSTRACTPURPOSE: Direct oral anticoagulants (DOACs) are recommended in preference to vitamin K antagonists (VKAs) for stroke prevention in patients with atrial fibrillation (AF) eligible for oral anticoagulation therapy; however, data and clinical experiences supporting the use of DOACs in patients with a body mass index ≥40 kg/m2 or weight >120 kg remain limited. The aim of this study was to evaluate the pharmacokinetic properties of DOACs in patients with AF and extreme obesity.METHODS: We enrolled all consecutiv...
Source: Clinical Therapeutics - August 9, 2021 Category: Drugs & Pharmacology Authors: Vincenzo Russo Dario Cattaneo Laura Giannetti Roberta Bottino Nunzia Laezza Umberto Atripaldi Emilio Clementi Source Type: research

Comparative Effectiveness and Safety of Direct Oral Anticoagulants in Obese Patients with Atrial Fibrillation
ConclusionsIn this large cohort of obese Veterans Health Administration system patients, the use of DOACs resulted in lower hemorrhagic complications than warfarin while maintaining efficacy on ischemic stroke prevention.
Source: Cardiovascular Drugs and Therapy - January 6, 2021 Category: Cardiology Source Type: research

Direct Oral Anticoagulants in Obesity: An Updated Literature Review.
Conclusions: Evidence indicates that each DOAC may have differences in outcomes when used in patients with a high BW/BMI. Currently, low-quality data are available that support avoiding dabigatran and considering apixaban or rivaroxaban; lack of sufficient data preclude a recommendation for edoxaban use in this patient population. PMID: 32443941 [PubMed - as supplied by publisher]
Source: The Annals of Pharmacotherapy - May 21, 2020 Category: Drugs & Pharmacology Authors: Sebaaly J, Kelley D Tags: Ann Pharmacother Source Type: research

Non-Vitamin K Antagonist Oral Anticoagulant for Atrial Fibrillation in Obese Patients
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It affects 1 in 4 adults aged>40 years,1 and is associated with a 5-fold increased risk of stroke.1 Hence, anticoagulants are universally recommended to prevent stroke and systemic embolism in patients with AF.1 The non-vitamin K antagonist oral anticoagulants (NOACs) are important alternatives to warfarin for prevention of arterial thromboembolism in patients with AF. Currently, the FDA has approved four NOACs for use in patients with AF: dabigatran is a thrombin inhibitor, while rivaroxaban, apixaban, and edoxaban are factor Xa inhibitors.
Source: The American Journal of Cardiology - April 22, 2020 Category: Cardiology Authors: Stephen Y Wang, Robert P Giugliano Tags: Review Article Source Type: research

Comparing the Efficacy and Safety of Direct Oral Anticoagulants With Warfarin in the Morbidly Obese Population With Atrial Fibrillation.
Conclusion and Relevance: Apixaban and rivaroxaban may be considered as alternatives to warfarin for atrial fibrillation or flutter in morbidly obese patients. Dabigatran use in morbidly obese patients needs caution until further studies are conducted. PMID: 30130979 [PubMed - as supplied by publisher]
Source: The Annals of Pharmacotherapy - August 22, 2018 Category: Drugs & Pharmacology Authors: Kido K, Ngorsuraches S Tags: Ann Pharmacother Source Type: research

Use of the Direct Oral Anticoagulants in Obese Patients: guidance from the SSC of the ISTH
This article is protected by copyright. All rights reserved.
Source: Journal of Thrombosis and Haemostasis - February 29, 2016 Category: Hematology Authors: K Martin, J Beyer‐Westendorf, BL Davidson, MV Huisman, PM Sandset, S Moll Tags: Recommendations and Guidelines Source Type: research

Rivaroxaban presents a better pharmacokinetic profile than dabigatran in an obese non-diabetic stroke patient
Novel oral anticoagulants (NOACs) are the recent therapeutic breakthrough in the thromboprophylaxis of non-valvular atrial fibrillation (NVAF). There are currently three different molecules approved for NVAF: dabigatran, rivaroxaban and apixaban. All three agents have demonstrated at least non-inferiority at major clinical endpoints compared to warfarin with their major advantage being the fixed-dose regimen that necessitates no regular blood tests and protects patients from the disastrous effects of infra-therapeutic (embolism) or supra-therapeutic (hemorrhage) anticoagulation.
Source: Journal of the Neurological Sciences - September 14, 2014 Category: Neurology Authors: Apostolos Safouris, Anne Demulder, Nikos Triantafyllou, Georgios Tsivgoulis Tags: Letter to the Editor Source Type: research

Ischemic Stroke in an Obese Patient Receiving Dabigatran
New England Journal of Medicine, Volume 368, Issue 25, Page 2440-2442, June 2013.
Source: New England Journal of Medicine - June 19, 2013 Category: Internal Medicine Tags: article Source Type: research

Acute pulmonary emboli in a patient on long-term dabigatran therapy.
CONCLUSIONS: Our patient developed acute bilateral PE despite receiving long-term anticoagulation with dabigatran. While it is possible that patient-specific factors resulted in reduced dabigatran exposure and efficacy, conclusions cannot be made. PMID: 23535815 [PubMed - in process]
Source: The Annals of Pharmacotherapy - April 1, 2013 Category: Drugs & Pharmacology Authors: Rafferty JA, Prom R, Kujawski SZ Tags: Ann Pharmacother Source Type: research