title: Target-specific oral anticoagulants in atrial fibrillation: results of phase III trials and comments on sub-analyses.
abstract: Dabigatran, rivaroxaban, apixaban and edoxaban administered in fixed doses and without routine laboratory monitoring have been compared to warfarin for the prevention of stoke in patients with nonvalvular atrial fibrillation (AF). Phase III data is currently available for dabigatran, rivaroxaban and apixaban. It is derived from three randomized controlled trials: RE-LY, ROCKET AF and ARISTOTLE. Dabigatran and apixaban appeared to be superior to warfarin for the primary endpoint of stroke or systemic embolism, while rivaroxaban was deemed non-inferior. The risk of major bleeding was modestly decreased overall with the new agents, while the risk of intracranial hemorrhage was substantially reduced. The results of ENGAGE AF-TIMI 48 comparing edoxaban to warfarin are still pending. Large, well designed clinical trials support the use of three new target-specific oral anticoagulants for the prevention of stroke in individuals with nonvalvular AF.
authors.affiliation: Department of Medicine, Hematology Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Howard 701, New York, NY 10065, USA. manthas@mskcc.org
authors.forename: Simon
authors.initials: S
authors.lastname: Mantha
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D017326:Clinical Trials, Phase III as Topic; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control
chemical_list: D000925:Anticoagulants