Frequent oral anticoagulant rivaroxaban linked to highest threat of bleeding problems

When identified with a blood clot or atrial fibrillation, sufferers are sometimes prescribed anticoagulants, or blood thinners, to stop a future clot.

In a examine of the three mostly prescribed blood thinners, the oral anticoagulant rivaroxaban, recognized by the model identify Xarelto, was related to a considerably larger threat of bleeding problems than apixaban (model identify Eliquis) and warfarin for sufferers with blood clots or atrial fibrillation.

The findings, reported on the 2023 American Society of Hematology’s Annual Assembly & Exposition, lined over 10 years of affected person knowledge from the Michigan Anticoagulation High quality Enchancment Initiative registry. The multi-center initiative is sponsored by Blue Cross Blue Defend of Michigan.

“We discovered the very best charges of bleeding amongst sufferers who took rivaroxaban, adopted by warfarin after which apixaban,” mentioned Jordan Ok. Schaefer, M.D., first writer and scientific affiliate professor of hematology at College of Michigan Medical Faculty.

“We adopted sufferers for over two years on common and have been capable of examine apixaban to rivaroxaban, one thing that has not but been finished in a randomized scientific trial. Whereas the findings ought to be confirmed with randomized research, they might have implications for suppliers as they choose anticoagulants for his or her sufferers.”

By their evaluation, researchers discovered that if 100 sufferers have been adopted over 1 12 months, rivaroxaban resulted in almost 40 bleeding occasions in comparison with round 25 for warfarin. Bleeding occasions have been related between apixaban and warfarin, however the latter treatment was related to extra main bleeds.

The speed of blood clots was larger with apixaban in comparison with warfarin, however researchers say it appeared largely pushed by different thrombotic occasions, which included occasions like coronary heart assaults.

Of the three medicines, apixaban was related to a decrease mortality charge than rivaroxaban and warfarin.

These three medicines are essentially the most generally prescribed anticoagulants for thrombosis and atrial fibrillation, and it’s important that we proceed to research the potential impact they carry as we try to greatest serve our sufferers.”

Geoffrey Barnes, M.D., M.Sc., senior writer and affiliate professor of cardiology-internal medication at U-M Medical Faculty

Extra authors embrace Josh Errickson, Ph.D., Xiaowen Kong, Naina Chipalkatti, M.D., Brian Haymart, R.N., Suman L. Wooden, M.D., MSCE, and James Froehlich, M.D., M.P.H., all of College of Michigan, Mona A. Ali, PharmD., Corewell Well being William Beaumont College Hospital, Scott Kaatz, D.O., M.Sc., Gregory D. Krol, M.D., each of Henry Ford Well being.