Re: Practical Prescribing: Direct oral anticoagulants
Dear Editor,
Some help in deciding which drug to use comes from an observational study from Jordan K Schaefer, MD et al.(1) at Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI (1). In clinical practice, over an average of 28.2 months, apixaban seemed the least harmful, less so than warfarin and rivaroxaban, both in terms of overall mortality, and new bleeds.
This is not a randomised controlled trial, but is longer in duration than many such. Thus it may be helpful in counselling patients on which medication is best for them.
Gareth Jones MRCP FRCPsych, retired. Caerffili.
(1) Jordan K Schaefer, MD et al, A comparison of bleeding events among patients on apixaban, rivaroxaban, and warfarin for atrial fibrillation and/or venous thromboembolism. American Society of Hematology 65th ASH Annual Meeting and Exposition,
December 9-12, 2023, San Diego, CA. https://ash.confex.com/ash/2023/webprogram/Paper184457.html
Rapid Response:
Re: Practical Prescribing: Direct oral anticoagulants
Dear Editor,
Some help in deciding which drug to use comes from an observational study from Jordan K Schaefer, MD et al.(1) at Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI (1). In clinical practice, over an average of 28.2 months, apixaban seemed the least harmful, less so than warfarin and rivaroxaban, both in terms of overall mortality, and new bleeds.
This is not a randomised controlled trial, but is longer in duration than many such. Thus it may be helpful in counselling patients on which medication is best for them.
Gareth Jones MRCP FRCPsych, retired. Caerffili.
(1) Jordan K Schaefer, MD et al, A comparison of bleeding events among patients on apixaban, rivaroxaban, and warfarin for atrial fibrillation and/or venous thromboembolism. American Society of Hematology 65th ASH Annual Meeting and Exposition,
December 9-12, 2023, San Diego, CA.
https://ash.confex.com/ash/2023/webprogram/Paper184457.html
Competing interests: No competing interests