Widespread oral anticoagulant rivaroxaban linked to highest danger of bleeding issues

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

In a research of the three mostly prescribed blood thinners, the oral anticoagulant rivaroxaban, recognized by the model identify Xarelto, was related to a considerably larger danger of bleeding issues 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 found the highest rates of bleeding among patients who took rivaroxaban, followed by warfarin and then apixaban,” mentioned Jordan Okay. Schaefer, M.D., first creator and medical affiliate professor of hematology at College of Michigan Medical Faculty.

“We followed patients for over two years on average and were able to compare apixaban to rivaroxaban, something that has not yet been done in a randomized clinical trial. While the findings should be confirmed with randomized studies, they may have implications for providers as they select anticoagulants for their patients.”

Via their evaluation, researchers discovered that if 100 sufferers had been adopted over 1 12 months, rivaroxaban resulted in almost 40 bleeding occasions in comparison with round 25 for warfarin. Bleeding occasions had been comparable between apixaban and warfarin, however the latter medicine 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 fee than rivaroxaban and warfarin.

These three medicines are probably 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 and greatest serve our sufferers.”

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

Extra authors embody Josh Errickson, Ph.D., Xiaowen Kong, Naina Chipalkatti, MD, Brian Haymart, RN, Suman L. Wooden, MD, MSCE, and James Froehlich, MD, MPH. Ali, PharmD., Corewell Well being William Beaumont College Hospital, Scott Kaatz, DO, M.Sc., Gregory D. Krol, MD, each of Henry Ford Well being.