Efficacy and safety of apixaban compared with aspirin in patients who previously tried but failed treatment with vitamin K antagonists: results from the AVERROES trial

In this prespecified analysis, the efficacy and safety of apixaban compared with aspirin was consistent in subgroups of patients who had previously attempted but failed vitamin K antagonist therapy (n=2216), irrespective of the reason for discontinuation.

The original AVERROES trial demonstrated that apixaban reduced the risk of stroke or systemic embolism by 55% compared with aspirin without an increase in major bleeding in patients with atrial fibrillation either who previously tried but failed vitamin K antagonists (VKA) therapy or who were expected to be unsuitable for VKA therapy.

 

The rates of bleeding were > 50% higher in patients who had previously failed warfarin compared with those who were deemed unsuitable for warfarin but had not previously been treated with VKAs.

 

This analysis therefore addressed whether the results of the original AVERROES trial can be applied to patients who had previously attempted but failed VKA therapy.