VIDEO: Real-world data show benefit of direct oral anticoagulants

WASHINGTON — In this Cardiology Today video perspective, Alpesh Amin, MD, professor and chairman of medicine at the University of California, Irvine, discusses two abstracts comparing direct oral anticoagulants to warfarin in real-world populations with nonvalvular atrial fibrillation presented at the American College of Cardiology Scientific Session.

According to Amin, in the last 5 or 6 years, direct oral anticoagulants have become more commonly prescribed to patients with nonvalvular AF for stroke prevention. Compared with warfarin, the newer drugs have shown benefit in terms of major bleeding in relation to intracranial hemorrhage.

Researchers for the studies analyzed whether results observed in clinical trial populations were similar in real-world settings.

“Apixaban (Eliquis, Bristol-Myers Squibb/Pfizer) was statistically significant in the real world in terms of reducing stroke as well as reducing bleed,” Amin said. “Rivaroxaban (Xarelto, Janssen Pharmaceuticals) was statistically significant in reducing stroke but also statistically significant in increasing bleeding compared to warfarin, [including] major bleeding, and dabigatran (Pradaxa, Boehringer Ingelheim) showed reduction in both stroke and bleeding but wasn't as statically significant. When one looks at the triple aim, which is looking at opportunities to improve efficacy and safety and quality, decrease utilization and improve customer service, these types of real-world data will hopefully help us continue to move in [that direction].”