Effectiveness and Safety of Apixaban Compared With Rivaroxaban for Patients With Atrial Fibrillation in Routine Practice: A Cohort Study

Retrospective analysis of data from 39,351 patients on apixaban, and 39,351 matched patients on rivaroxaban concludes those prescribed apixaban had a lower rate of both ischaemic stroke or systemic embolism and bleeding compared with those prescribed rivaroxaban.

SPS commentary:

The incidence rate of ischaemic stroke or systemic embolism was 6.6 per 1000 person-years for adults prescribed apixaban vs 8.0 per 1000 person-years for those prescribed rivaroxaban (HR 0.82 [95% CI 0.68 to 0.98]; rate difference, 1.4 fewer events per 1000 person-years [0.0 to 2.7]). Adults prescribed apixaban also had a lower rate of gastrointestinal bleeding or intracranial haemorrhage (12.9 per 1000 person-years) vs those prescribed rivaroxaban (21.9 per 1000 person-years), HR 0.58 (CI, 0.52 to 0.66) and a rate difference of 9.0 fewer events per 1000 person-years (CI 6.9 to 11.1).

Annals of Internal Medicine