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Novel oral anticoagulants dosed incorrectly in many patients with atrial fibrillation

KEY POINT

Results of a retrospective analysis of patients with atrial fibrillation (AF) initiated on apixaban (Eliquis—Bristol-Myers Squibb), dabigatran (Pradaxa—Boehringer Ingelheim), or rivaroxaban (Xarelto—Bayer, Janssen) showed that these medications were either overdosed in those with kidney impairment, resulting in a higher risk of major bleeding for all three of the medications, or underdosed in those without an indication for lower doses, resulting in a higher risk of stroke in apixaban-treated patients.

SOURCES

Yao X, et al. Non-vitamin K antagonist oral anticoagulant dosing in patients with atrial fibrillation and renal dysfunction. J Am Coll Cardiol. 2017;69:2779–90.

Pokorney SD, et al. When less is not more. J Am Coll Cardiol. 2017;69:2791–3.