Apixaban Finally Showing Superiority Over Warfarin In Clinical Trial
With the publication of “Apixaban versus Warfarin in Patients with Atrial Fibrillation” (the ARISTOTLE trial) in the New England Journal of Medicine, the third drug in a series of medications designed to attack thrombin in the clotting cascade. The study was announced with quite a fanfare in Europe as cardiologists, financial analysts and reporters gushed forth with ‘mega-blockbuster’ praise this past weekend.
And for good reason.
This is the first trial to conclude that this direct Factor Xa inhibitor demonstrated a mortality superiority over warfarin when treating patients with non-rheumatic atrial fibrillation (Two earlier trials showed a trend that way, but only reached mortality equivalency, not superiority: the direct thrombin inhibitor dabigratran’s Re-LY Trial and rival direct Factor Xa inbibitor rivaroxaban’s ROCKET-AF trial). Specifically, the 18,201-patient ARTISTOLE trial showed
The rate of the primary outcome (major bleeding) was 1.27% per year in the apixaban group, as compared with 1.60% per year in the warfarin group (hazard ratio with apixaban, 0.79; 95% confidence interval [CI], 0.66 to 0.95; P
*This blog post was originally published at Dr. Wes*
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