Warfarin is a blood-thinning drug that requires continuous blood tests to ensure its efficacy and safety, and there are numerous foods and other drugs that interact with it. Now, another option enters the stage to treat atrial fibrillation: non-vitamin K antagonist oral anticoagulants (NOACs).
Mayo Clinic cardiologist Peter Noseworthy, MD, said that past study data shows that NOACs are “at least as good as warfarin in preventing stroke in atrial fibrillation,” and the present study aims to investigate and compare the effectiveness and safety between three NOACs: dabigatran, rivaroxaban, and apixaban.
The three new candidates for treating atrial fibrillation are known to work quickly and are easily cleared from the body. Plus, the require many fewer blood tests for monitoring than a warfarin prescription does, but little more is known about their effectiveness and safety in comparison to warfarin.
The Mayo Clinic study involved tested these two qualities in an analysis of patients currently taking the medications, looking for any incidence of stroke, systemic embolism, and bleeding rates as measures of the drugs’ efficacy and safety.
After making comparisons between the three NOACs, they found no significant risk of stroke or systemic embolism. However, patients taking apixaban were less likely to experience major bleeding than those taking dabigatran or rivaroxaban, and rivaroxaban was more likely to cause major bleeding and intracranial bleeding compared to dabigatran.
A related study laid out the differences between each of the three NOACs and warfarin:
- Patients with non-valvular atrial fibrillation taking apixaban were less likely to have a stroke or major bleeding, compared to warfarin
- With dabigatran, patients were less likely to experience major bleeding, but there was no difference of stroke risk, compared to warfarin
- Patients taking rivaroxaban showed the drug had no clear benefit over warfarin
"Individual treatment decisions still are in the hands of the providers and their patients," says Dr. Noseworthy. "However, these findings will help me treat my patients, and I hope will help my colleagues, as well. Never stop taking prescribed medication without talking to your doctor."
The current Mayo Clinic study was published in the
CHEST Journal.
Source:
Mayo Clinic
