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Concerns for Bleeding in the Elderly with the Use of Direct Oral Anticoagulants

Michelle Min1, Stephanie Sibicky2

  • 1North Shore University Hospital, Manhasset, New York. At the time of writing, she was a pharmacy student at Northeastern University School of Pharmacy, Boston, Massachusetts.

The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists
|May 24, 2018
PubMed

Insights

Direct oral anticoagulants (DOACs) are alternatives to warfarin for atrial fibrillation. Limited safety data exist for older adults, especially regarding bleeding risks with these novel anticoagulants.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Direct oral anticoagulants (DOACs) have emerged as alternatives to warfarin for preventing cardioembolic complications in nonvalvular atrial fibrillation since 2010.
  • Limited safety data, particularly concerning bleeding risks, are available for DOACs in elderly populations (≥75 years).

Purpose of the Study:

  • To review the available literature on bleeding risks associated with each DOAC in older adults.
  • To highlight the need for further safety data in this specific demographic.

Main Methods:

  • Review of existing literature, including retrospective cohort studies, secondary analyses, and subgroup analyses.
  • Focus on gastrointestinal, intracranial, and major bleeding events as defined by the International Society on Thrombosis and Haemostasis.

Main Results:

  • Analysis of bleeding risks for individual DOACs in adults aged 75 and older.
  • Identification of gaps in current safety data for DOACs in the elderly population.

Conclusions:

  • Further research is crucial to establish comprehensive safety profiles of DOACs in older adults.
  • Understanding specific bleeding risks is essential for optimizing anticoagulant therapy in the geriatric population.

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