anticoagulants, oral factor Xa inhibitors, apixaban
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2011 Sep 15;365(11):981-92 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, non valvular, stroke, ischemic, cerebral infarction, embolic The Use of
anticoagulants, oral factor Xa inhibitors, apixaban, 5 mg twice daily
As Treatment, Chronic
Is better Than
warfarin
To reduce stroke or systemic embolism at 1.8 years (1.3% apixaban VS 1.6% warfarin) witout increasing major bleeding (2.1% apixaban VS 3.1% warfarin). Quite similar rate of all-cause death (3.5% apixaban VS 3.9% warfarin)
Cochrane Database Syst Rev. 2018 Mar 06;3:CD008980 Systematic Review, Cochrane Review
IN atrial fibrillation, non valvular, stroke, ischemic, cerebral infarction, embolic, all-cause mortality The Use of
direct oral anticoagulants, oral factor Xa inhibitors, apixaban, edoxaban, rivaroxaban, idraparinux
As Treatment, Chronic
Is better Than
oral anticoagulants, vitamin K antagonists, warfarin
To Results to be defined
N Engl J Med. 2011 Mar 3;364(9):806-17. Epub 2011 Feb 10 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, non valvular, stroke, ischemic, cerebral infarction, embolic, patients not suitable for vitamine K antagonists, warfarin The Use of
anticoagulants, oral factor Xa inhibitors, apixaban
As Treatment, Chronic
Is better Than
aspirin
To reduce stroke or systemic embolism (1.6% per year apixaban VS 3.7% aspirin) while not increasing major bleeding (1.4% per year apixaban VS 1.2% aspirin)
N Engl J Med. 2011 Aug 25;365(8):699-708. [Epub 2011 Jul 24] Randomized Controlled Trial, Multicenter Study
IN coronary disease, acute coronary syndrome The Use of
anticoagulants, oral factor Xa inhibitors, apixaban, 5 mg twice daily
As Treatment, Chronic
Is worse Than
placebo
To improve results at 8 months: it increase in major bleeding events (1.3% apixaban VS 0.5% placebo) and did not reduced cardiovascular events (7.5% apixaban VS 7.9% placebo)
N Engl J Med. 2013 Aug 29;369(9):799-808 Randomized Controlled Trial, Multicenter Study
IN thromboembolic disease The Use of
anticoagulants, oral factor Xa inhibitors, apixaban, 10 mg twice daily for 7 days, then 5 mg twice daily for 6 months
As Treatment, Acute
Is equal Than
full dose LMWH enoxaparin initially, followed by warfarin
To reduce recurrent symptomatic venous thromboembolism or related death: 2.3% apixaban VS 2.7% enoxaparin+warfarin, p NS. Less major bleedings with apixaban: 0.6% apixaban VS 1.8% enoxaparin+warfarin
N Engl J Med. 2013 Feb 21;368(8):699-708 Randomized Controlled Trial, Multicenter Study
IN thromboembolic disease, idiopathic The Use of
anticoagulants, oral factor Xa inhibitors, apixaban, 2.5 or 5 mg twice daily, extended treatment for one year after 6-12 months
As Treatment, Chronic
Is better Than
non extended treatment, only 6-12 months, placebo afterwards
To reduce new episodes of symptomatic venous thromboembolism (1.7% apixaban both doses VS 8.8% placebo). Apixaban increased nonmajor bleeding (3-4% apixaban VS 2% placebo) but not major bleeding (0.2% apixaban VS 0.5% placebo)
N Engl J Med. 2011 Dec 8;365(23):2167-77. Epub 2011 Nov 13 Randomized Controlled Trial, Multicenter Study
IN thromboembolic disease, medical patients The Use of
anticoagulants, oral factor Xa inhibitors, apixaban, 2.5 mg twice daily for 30 days
As Treatment, Acute
Is worse Than
low molecular weight heparin (LMWH), enoxaparin 40 mg/d for 6-14 days
To improve outcomes at 30 days: thromboembolic events were similar (2.7% apixaban VS 3% enoxaparin, p=0.44) and major bleeding increased (0.5% apixaban VS 0.2% enoxaparin, p=0.04)