title: Indirect Comparison of Novel Oral Anticoagulants in Women with Nonvalvular Atrial Fibrillation.
abstract: For nonvalvular atrial fibrillation (NVAF), novel oral anticoagulants (NOACs) have been found noninferior to warfarin for stroke/systemic embolization prevention, and major bleeding events. Recent meta-analysis of NOACs versus warfarin in atrial fibrillation (AF) showed that women on warfarin have greater risk of stroke/embolism than men, and when both are treated with NOACs, differences disappear.
  
  
  
  NOACs differ in pharmacologic properties, thus they may differ from one another in their effects on women with AF. Using dose-adjusted warfarin as the common comparator, an indirect comparison of rivaroxaban, apixaban, dabigatran 110 and 150 mg, and edoxaban 30 and 60 mg for efficacy (stroke/embolism prevention) and safety (major bleeding events) in women with AF was performed. Data from ROCKET-AF, RE-LY, ENGAGE AF TIMI, and ARISTOTLE were analyzed and compared according to the Bucher method.
  
  
  
  No significant difference was found for any NOAC compared with alternatives in safety or efficacy for women with AF. Examination of odds ratio comparisons alone showed possible favorable efficacy in dabigatran 150 mg, and unfavorable efficacy with favorable safety in edoxaban 30 mg.
  
  
  
  NOACs may slightly differ in their effect in women; the potential differences are very small and likely clinically negligible. Thus, NOACs can be used interchangeably in women according to patient and physician preferences to increase adherence.
authors.affiliation: 1 Rush University Medical Center , Chicago, Illinois.
authors.forename: Alex
authors.initials: A
authors.lastname: Moseley
authors.affiliation: 2 Division of Cardiology, John H. Stroger Jr. Hospital of Cook County, Rush University Medical Center , Chicago, Illinois.
authors.forename: Rami
authors.initials: R
authors.lastname: Doukky
authors.affiliation: 3 Division of Cardiology, Rush University Medical Center , Chicago, Illinois.
authors.forename: Kim Allan
authors.initials: KA
authors.lastname: Williams
authors.affiliation: 1 Rush University Medical Center , Chicago, Illinois.
authors.forename: Amir K
authors.initials: AK
authors.lastname: Jaffer
authors.affiliation: 3 Division of Cardiology, Rush University Medical Center , Chicago, Illinois.
authors.forename: Annabelle Santos
authors.initials: AS
authors.lastname: Volgman
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D000069604:Dabigatran / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D016017:Odds Ratio; D011720:Pyrazoles / Q000009:adverse effects / Q000627:therapeutic use; D011725:Pyridines / Q000009:adverse effects / Q000627:therapeutic use; D011728:Pyridones / Q000009:adverse effects / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000069552:Rivaroxaban / Q000009:adverse effects / Q000627:therapeutic use; D020521:Stroke / Q000517:prevention & control*; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D011720:Pyrazoles; D011725:Pyridines; D011728:Pyridones; D013844:Thiazoles; C522181:apixaban; D014859:Warfarin; D000069552:Rivaroxaban; D000069604:Dabigatran; C552171:edoxaban
keywords: anticoagulation; arrhythmia; atrial fibrillation; gender; women