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Updated: Jun 30, 2026
23:33
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.
Summary
Direct oral anticoagulants like edoxaban and apixaban help prevent stroke in atrial fibrillation (AF) patients. Edoxaban showed a lower risk of stroke or embolism compared to apixaban in Italian patients, especially older adults.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Direct oral anticoagulants (DOACs) are recommended for thromboembolism prevention in atrial fibrillation (AF).
- Randomized controlled trials (RCTs) have not directly compared edoxaban and apixaban.
- Real-world data is crucial for comparing these DOACs in clinical practice.
Purpose of the Study:
- To retrospectively compare clinical outcomes between edoxaban and apixaban in Italian AF patients.
- To evaluate effectiveness (ischemic stroke/systemic embolism) and safety (major bleeding).
- To analyze outcomes in the overall population and by age group (≥80 years and <80 years).
Main Methods:
- Utilized the Italian IQVIA Longitudinal Patient Database (January 2016-December 2021).
- Included adult patients with AF newly initiating edoxaban or apixaban.
- Employed propensity score matching to balance baseline characteristics between treatment groups.
- Calculated incidence rates per 100 person-years and hazard ratios (HRs) with 95% confidence intervals (CIs).
Main Results:
- 8,444 patients were identified; 3,188 received edoxaban and 5,256 received apixaban.
- After matching, the risk of ischemic stroke/systemic embolism (IS/SE) was significantly lower for edoxaban vs. apixaban in the overall population (HR: 0.78, 95% CI: 0.61-0.99).
- Edoxaban also showed a significantly lower IS/SE risk in patients aged ≥80 years (HR: 0.61, 95% CI: 0.44-0.86).
- No significant differences in major bleeding (MB) risk were observed between the two drugs.
- No significant differences in IS/SE or MB risk were found in patients <80 years.
Conclusions:
- Edoxaban demonstrated a significantly lower risk of IS/SE compared to apixaban in the overall AF patient population.
- This benefit was particularly pronounced in patients aged ≥80 years.
- Edoxaban use was not associated with an increased risk of major bleeding compared to apixaban in these patient groups.
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