The Controversy Continues Again: which Direct Anticoagulant is More Effective and Safe when Administered to Patients with Atrial Fibrillation?
Open Access
- 2 September 2020
- journal article
- research article
- Published by Silicea - Poligraf in Rational Pharmacotherapy in Cardiology
- Vol. 16 (4), 635-637
- https://doi.org/10.20996/1819-6446-2020-08-09
Abstract
The data from the observational study of M. Fralick et al. were analyzed in the article. The authors analyzed a large database of patients with atrial fibrillation and concluded that rivaroxaban is inferior to apixaban in its ability to prevent ischemic stroke and systemic embolism and is more likely to cause bleeding. Serious methodological defects of the analysis take place. No statistical methods are capable of correcting the absence of such important information in the database as the doctor's motives for prescribing a particular drug, as well as the patient's adherence to taking it. It is also noted that the patients included in the study, according to clinical characteristics, did not correspond to the typical population of patients with atrial fibrillation. The author considers the conclusions made in the mentioned work to be unauthorized.Keywords
This publication has 9 references indexed in Scilit:
- Effectiveness and Safety of Apixaban Compared With Rivaroxaban for Patients With Atrial Fibrillation in Routine PracticeAnnals of Internal Medicine, 2020
- Challenges in comparing the non-vitamin K antagonist oral anticoagulants for atrial fibrillation-related stroke preventionEP Europace, 2017
- ONCE AGAIN ABOUT THE HIERARCHY OF EVIDENCES IN MEDICINE OR WHETHER IT IS POSSIBLE TO CHOOSE THE MOST EFFECTIVE AND SAFE DRUG WITH THE HELP OF OBSERVATIONAL STUDIESRational Pharmacotherapy in Cardiology, 2017
- Off-Label Dosing of Non-Vitamin K Antagonist Oral Anticoagulants and Adverse OutcomesJournal of Invasive Cardiology, 2016
- Randomised Clinical Trials and Observational Studies: the Ratio in the Hierarchy of Evidence of the Efficacy of DrugsRational Pharmacotherapy in Cardiology, 2016
- Apixaban versus Warfarin in Patients with Atrial FibrillationThe New England Journal of Medicine, 2011
- Rivaroxaban versus Warfarin in Nonvalvular Atrial FibrillationThe New England Journal of Medicine, 2011
- Apixaban in Patients with Atrial FibrillationThe New England Journal of Medicine, 2011
- Dabigatran versus Warfarin in Patients with Atrial FibrillationThe New England Journal of Medicine, 2009