TY - JOUR
T1 - A comparison of front-line oral anticoagulants for the treatment of non-valvular atrial fibrillation
T2 - effectiveness and safety of direct oral anticoagulants in the FANTASIIA registry
AU - Esteve-Pastor, María Asunción
AU - Rivera-Caravaca, José Miguel
AU - Ruiz-Ortiz, Martín
AU - Muñiz, Javier
AU - Roldán-Rabadán, Inmaculada
AU - Otero, Déborah
AU - López-Gálvez, Raquel
AU - Cequier, Ángel
AU - Bertomeu-Martínez, Vicente
AU - Badimón, Lina
AU - Anguita, Manuel
AU - Lip, Gregory Y. H.
AU - Marín, Francisco
AU - FANTASIIA Investigators
PY - 2022/8
Y1 - 2022/8
N2 - INTRODUCTION: For a long time, vitamin K antagonists (VKA) were the only oral anticoagulation therapy available to reduce adverse events in atrial fibrillation (AF) patients. Direct-acting oral anticoagulants (DOAC) are at least as effective and safe as VKA with few drug interactions, rapid onset, and short half-life. Four DOACs, dabigatran, apixaban, rivaroxaban, and edoxaban, have demonstrated efficacy and safety for treatment in AF patients.AREAS COVERED: The purpose of this review article is to analyze the current evidence in clinical trials and in real-world populations and performed a new analysis with the estimated effect of those DOACs over the VKA population from the FANTASIIA registry.EXPERT OPINION: In the absence of randomized, controlled head-to-head comparisons between DOACs, high-quality observational data can provide useful information on the comparative effectiveness of DOACs. Current clinical guidelines recommend the management of oral anticoagulation in AF patients with DOACs over VKA for stroke prevention; however, many guidelines generally do not suggest a specific DOAC choice in clinical practice. The revised evidence in this manuscript and our real experience reflects that apixaban and dabigatran show the best efficacy and safety profile.
AB - INTRODUCTION: For a long time, vitamin K antagonists (VKA) were the only oral anticoagulation therapy available to reduce adverse events in atrial fibrillation (AF) patients. Direct-acting oral anticoagulants (DOAC) are at least as effective and safe as VKA with few drug interactions, rapid onset, and short half-life. Four DOACs, dabigatran, apixaban, rivaroxaban, and edoxaban, have demonstrated efficacy and safety for treatment in AF patients.AREAS COVERED: The purpose of this review article is to analyze the current evidence in clinical trials and in real-world populations and performed a new analysis with the estimated effect of those DOACs over the VKA population from the FANTASIIA registry.EXPERT OPINION: In the absence of randomized, controlled head-to-head comparisons between DOACs, high-quality observational data can provide useful information on the comparative effectiveness of DOACs. Current clinical guidelines recommend the management of oral anticoagulation in AF patients with DOACs over VKA for stroke prevention; however, many guidelines generally do not suggest a specific DOAC choice in clinical practice. The revised evidence in this manuscript and our real experience reflects that apixaban and dabigatran show the best efficacy and safety profile.
KW - Atrial fibrillation
KW - Direct-acting oral anticoagulants
KW - antithrombotic therapy
KW - oral anticoagulation
KW - Anticoagulants
KW - Stroke
KW - Administration, Oral
KW - Humans
KW - Pyridones
KW - Dabigatran
KW - Rivaroxaban
KW - Registries
KW - Atrial Fibrillation
KW - Vitamin K
UR - http://www.scopus.com/inward/record.url?scp=85136014601&partnerID=8YFLogxK
U2 - 10.1080/14656566.2022.2109961
DO - 10.1080/14656566.2022.2109961
M3 - Review article
C2 - 35924672
SN - 1465-6566
VL - 23
SP - 1457
EP - 1465
JO - Expert Opinion on Pharmacotherapy
JF - Expert Opinion on Pharmacotherapy
IS - 12
ER -