ANN ARBOR, Mich. — Sufferers recognized with blood clots or atrial fibrillation, a sort of irregular heartbeat, are sometimes prescribed medicines referred to as anticoagulants (blood thinners) to stop future clots. Nevertheless, a dire new research reveals that the favored blood thinner Xarelto has a better threat of triggering bleeding issues.

Researchers from the College of Michigan targeted on the three mostly used oral anticoagulants: rivaroxaban (Xarelto), apixaban (Eliquis), and warfarin. Analyzing over a decade of affected person knowledge from the Michigan Anticoagulation High quality Enchancment Initiative registry, the research discovered that rivaroxaban was linked to a notably greater threat of bleeding than apixaban and warfarin in sufferers with blood clots or atrial fibrillation.

“We discovered the very best charges of bleeding amongst sufferers who took rivaroxaban, adopted by warfarin after which apixaban,” says research first creator Dr. Jordan Schaefer, a medical affiliate professor of hematology on the College of Michigan Medical College, in a university release.

“We adopted sufferers for over two years on common and had been capable of examine apixaban to rivaroxaban, one thing that has not but been performed in a randomized medical trial. Whereas the findings ought to be confirmed with randomized research, they might have implications for suppliers as they choose anticoagulants for his or her sufferers.”

Researchers quantified the chance by estimating that for each 100 sufferers noticed over a 12 months, rivaroxaban would end in almost 40 bleeding occasions in comparison with round 25 for warfarin. Though the variety of bleeding occasions was related for apixaban and warfarin, the latter was related to extra extreme bleeds.

Whereas the speed of blood clots was greater with apixaban than with warfarin, researchers recommend this was largely on account of different thrombotic occasions like heart attacks. When it comes to mortality, apixaban was related to a decrease demise fee in comparison with each rivaroxaban and warfarin.

“These three medicines are essentially the most generally prescribed anticoagulants for thrombosis and atrial fibrillation, and it’s important that we proceed to analyze the doable impact they carry as we try and finest serve our sufferers,” notes research senior creator Dr. Geoffrey Barnes, an affiliate professor of cardiology-internal drugs at College of Michigan Medical College.

This research underscores the necessity for cautious consideration in prescribing anticoagulants, given the various dangers related to completely different medicines.

The research was offered on the 2023 American Society of Hematology’s Annual Meeting & Exposition.

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