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Updated: Jun 30, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Edoxaban versus Apixaban Outcomes Differences in 8,444 Patients with Atrial Fibrillation from Italy: A Real-World Use
Angel Valladares1, Joseph Imperato1, Sidharth Gupta2
1IQVIA, New York, New York, United States.
Background:
Based on efficacy and safety data from randomized controlled trials (RCTs) and real-world studies, direct oral anticoagulants are recommended for thromboembolism prevention in patients with atrial fibrillation (AF). However, no RCTs have compared edoxaban with apixaban.
Objectives:
This study aimed to retrospectively compare clinical outcomes for patients with AF in Italy (overall and by age group) who received edoxaban versus apixaban.
Methods:
Adult patients with AF who newly initiated an edoxaban or apixaban prescription between January 2016 and December 2021 were identified from the Italian IQVIA ® Longitudinal Patient Database. Patient characteristics were summarized. Propensity score matching was used to balance baseline characteristics between the edoxaban and apixaban groups. Clinical outcomes of effectiveness (ischemic stroke [IS] or systemic embolism [SE]) and safety (any major bleeding [MB]) were compared. Incidence rates per 100 person-years and hazard ratios (HRs) with 95% CIs were computed.
Results:
Among 8,444 identified patients, 37.8% ( n = 3,188) were prescribed edoxaban and 62.2% ( n = 5,256) were prescribed apixaban. After matching, patient characteristics were similar between cohorts. The post-matching risk (HR, 95% CI) of IS/SE was significantly lower for edoxaban versus apixaban in the overall population (0.78, 0.61-0.99; p = 0.04) and in patients aged ≥80 years (0.61, 0.44-0.86; p < 0.01), with a similar risk for MB for edoxaban versus apixaban. No significant differences were observed between edoxaban and apixaban among patients aged <80 years (all p > 0.05).
Conclusion:
IS/SE risk was significantly lower for edoxaban versus apixaban, without an increased MB risk among patients with AF overall and those aged ≥80 years.
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