Risks and benefits of DOACs vs. warfarin in a real world setting

U.K. researchers examined the correlation between direct oral anticoagulants (DOACs) and bleeding outcomes as compared with the relationship between warfarin and the same endpoints. The team from the University of Nottingham designed a prospective open-cohort study, recruiting participants from general practices.

U.K. researchers examined the correlation between direct oral anticoagulants (DOACs) and bleeding outcomes as compared with the relationship between warfarin and the same endpoints. The team from the University of Nottingham designed a prospective open-cohort study, recruiting participants from general practices. Specifically, the investigators targeted users of warfarin, dabigatran, rivaroxaban, or apixaban from 2011–16 who had no anticoagulant prescriptions in the year prior to study entry. With a study population of more than 196,000, the research focused on major bleeding resulting in hospitalization or death. In this real-world setting, apixaban was found to be the safest DOAC choice. The risks of major, intracranial, and gastrointestinal bleeding were all lower with this agent compared with warfarin. The risks of death for any reason, however, were higher with both rivaroxaban and low-dose apixaban than with warfarin.