1. Comparative safety and effectiveness of non-vitamin K oral anticoagulants versus warfarin in patients with non-valvular atrial fibrillation: A network meta-analysis
- Author
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Yi-Hsin Chan, Shao-Wei Chen, Chih-Yu Chan, and Tze-Fan Chao
- Subjects
Atrial fibrillation ,Dabigatran ,Non-vitamin K antagonist oral anticoagulants ,Real-world evidence ,Medicine (General) ,R5-920 - Abstract
Background: The introduction of non-vitamin K antagonist oral anticoagulants (NOACs), with a non-inferior or superior clinical efficacy profile compared to vitamin K antagonists (VKAs), has significantly improved the safety profile and treatment adherence of patients with non-valvular atrial fibrillation (AF). However, few studies have compared the effectiveness and safety of NOACs. Therefore, we conducted this systematic review and network meta-analysis to compare the safety and clinical effectiveness of NOACs and VKAs in patients with non-valvular AF. Methods: An online bibliographic search was conducted to retrieve real-world evidence studies published between January 2019 and June 2022. Results: Dabigatran was associated with lower risks of major bleeding, ischemic stroke, and intracranial hemorrhage than warfarin. Among the NOACs, only dabigatran had a lower risk of all-cause mortality than warfarin. Dabigatran was also associated with lower risks of major bleeding and intracranial hemorrhage than rivaroxaban. Conclusion: Our meta-analysis confirms that dabigatran's real-world safety and clinical effectiveness align with the results of pivotal clinical trials.
- Published
- 2024
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