THE SAFETY OF APIXABAN COMPARED TO CONVENTIONAL ANTICOAGULANT THERAPY: SYSTEMATIC REVIEW AND META-ANALYSIS

Omar Almohammed, Nova Southeastern University
Catherine Harrington, Nova Southeastern University

Abstract

Objective. Investigating the safety of apixaban compared to warfarin (± enoxaparin) in combined patient populations. Background. The safety of apixaban has been studied in specific different patient populations. However, the cumulative safety of apixaban has not been studied before. Methods. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and ClinicalTrials.gov were searched up to November 2015. Six original articles comparing apixaban with warfarin ± Enoxaparin were included. All data regarding bleeding were pooled in Review Manager Software, using Mantel-Haenszel methods with a Random-effects model. Heterogeneity was assessed using the I2 test. The risk ratios (RR) and 95% confidence intervals of each study were calculated and pooled. Results. Apixaban was associated with a lower risk of major bleeding (RR=0.50, 95%CI (0.26, 0.97), I2=56%), clinically relevant non- major bleeding (RR=0.60, 95%CI (0.53, 0.69), I2=48%), major or clinically relevant non-major bleeding (RR=0.61, 95% CI (0.56, 0.67), I2=79%), minor bleeding (RR=0.73, 95%CI (0.69, 0.78), I2=51%), and any bleeding event (RR=0.65, 95%CI (0.62, 0.69), I2=74%). Conclusion. Apixaban was found to be safer than conventional anticoagulant therapy in a combined population. Grants. No grant was used for this project.

 
Feb 12th, 12:00 AM

THE SAFETY OF APIXABAN COMPARED TO CONVENTIONAL ANTICOAGULANT THERAPY: SYSTEMATIC REVIEW AND META-ANALYSIS

POSTER PRESENTATIONS

Objective. Investigating the safety of apixaban compared to warfarin (± enoxaparin) in combined patient populations. Background. The safety of apixaban has been studied in specific different patient populations. However, the cumulative safety of apixaban has not been studied before. Methods. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and ClinicalTrials.gov were searched up to November 2015. Six original articles comparing apixaban with warfarin ± Enoxaparin were included. All data regarding bleeding were pooled in Review Manager Software, using Mantel-Haenszel methods with a Random-effects model. Heterogeneity was assessed using the I2 test. The risk ratios (RR) and 95% confidence intervals of each study were calculated and pooled. Results. Apixaban was associated with a lower risk of major bleeding (RR=0.50, 95%CI (0.26, 0.97), I2=56%), clinically relevant non- major bleeding (RR=0.60, 95%CI (0.53, 0.69), I2=48%), major or clinically relevant non-major bleeding (RR=0.61, 95% CI (0.56, 0.67), I2=79%), minor bleeding (RR=0.73, 95%CI (0.69, 0.78), I2=51%), and any bleeding event (RR=0.65, 95%CI (0.62, 0.69), I2=74%). Conclusion. Apixaban was found to be safer than conventional anticoagulant therapy in a combined population. Grants. No grant was used for this project.