Best Oral Anticoagulants?

Five oral anticoagulants are available in the UK for stroke prevention in patients with non-valvular atrial fibrillation "NVAF).

Reporting at the European Society of Cardiology Congress 2016 in Rome, Italy, a UK team and colleagues in other nations compared these therapies.

Gregory Lip of Birmingham City Hospital, Birmingham, UK and colleagues reported that "When all the factors that distinguish oral anticoagulants and their relative importance are considered in a multi-criteria decision analysis, dabigatran was ranked highest and warfarin lowest."

The drugs were apixaban, dabigatran, edoxaban, rivaroxaban, and warfarin.

The final evaluation model included nine clinical and three non-clinical criteria.

Clinical criteria were ranked based on expected changes in clinical implications from the worst to best performing treatment, as demonstrated in clinical trials.

Those criteria were: availability of reversal agent, real-world evidence, interaction with food, dyspepsia, non-major bleeding, other major bleeding, hemorrhagic stroke, GI bleeding, intracranial bleeding, myocardial infarction, systemic embolism, and ischemic stroke.