Comparison of potential pharmacokinetic drug interactions in patients with atrial fibrillation and changing from warfarin to non-vitamin K oral anticoagulant therapy

Bernaitis, Nijole; Badrick, Tony; Anoopkumar‐Dukie, Shailendra

doi:10.1007/s11239-021-02466-8

Cited by 2 publications

(3 citation statements)

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“…147 Patient preference and convenience of DOACs were also identified as a major reason for the switch from VKA to DOAC. 44 73 78 145 General practitioner or specialist recommendations were the top reasons for VKA to DOAC switch in the study by Bernaitis et al 148 In a survey of physicians managing ischaemic stroke in patients with AF, 83% said they routinely switched patients to a DOAC for those who experience ischaemic stroke on VKA while only 38% did so for patients experiencing ischaemic stroke while on DOAC. 149 The major reason for not switching while on DOAC was the paucity of randomised trial on switching.…”

Section: Reasons For Oac Switchingmentioning

confidence: 99%

Oral anticoagulant switching in patients with atrial fibrillation: a scoping review

et al. 2023

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IntroductionOral anticoagulants (OACs) prevent stroke in patients with atrial fibrillation (AF). Several factors may cause OAC switching.ObjectivesTo examine the phenomenon of OAC switching in patients with AF, including all available evidence; frequency and patterns of switch, clinical outcomes, adherence, patient-reported outcomes, reasons for switch, factors associated with switch and evidence gaps.DesignScoping review.Data sourcesMEDLINE, Embase and Web of Science, up to January 2022.ResultsOf the 116 included studies, 2/3 examined vitamin K antagonist (VKA) to direct-acting OAC (DOAC) switching. Overall, OAC switching was common and the definition of an OAC switch varied across. Switching from VKA to dabigatran was the most prevalent switch type, but VKA to apixaban has increased in recent years. Patients on DOAC switched more to warfarin than to other DOACs. OAC doses involved in the switches were hardly reported and patients were often censored after the first switch. Switching back to a previously taken OAC (frequently warfarin) occurred in 5%–21% of switchers.The risk of ischaemic stroke and gastrointestinal bleeding in VKA to DOAC switchers compared with non-switchers was conflicting, while there was no difference in the risk of other types of bleeding. The risk of ischaemic stroke in switchers from DOAC versus non-switchers was conflicting. Studies evaluating adherence found no significant changes in adherence after switching from VKA to DOAC, however, an increase in satisfaction with therapy were reported. Reasons for OAC switch, and factors associated with OAC switch were mostly risk factors for stroke and bleeding. Clinical outcomes, adherence and patient-reported outcomes were sparse for switches from DOACs.ConclusionsOAC switching is common in patients with AF and patients often switch back to an OAC they have previously been on. There are aspects of OAC switching that have received little study, especially in switches from DOACs.

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Section: Reasons For Oac Switchingmentioning

confidence: 99%

Oral anticoagulant switching in patients with atrial fibrillation: a scoping review

et al. 2023

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“…Cerebral amyloid angiopathy (CAA), which is one of the three pathological hallmarks of AD, is present in more than 80% of AD patients, is characterized by the accumulation of Aβ in cortical and leptomeningeal blood vessels, and can directly contribute to cognitive decline and dementia by causing vascular lesions [5][6][7][8]. Oral anticoagulant, such as warfarin and rivaroxaban, showed beneficial effects for the prevention and treatment of stroke associated with AF [9,10]. However, some reports indicated that the application of anticoagulant may increase the risk of intracerebral hemorrhages in patients with both CAA and atrial fibrillation [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…Oral anticoagulant, such as warfarin and rivaroxaban, showed beneficial effects for the prevention and treatment of stroke associated with AF [9,10]. However, some reports indicated that the application of anticoagulant may increase the risk of intracerebral hemorrhages in patients with both CAA and atrial fibrillation [9][10][11][12]. Moreover, warfarin had a higher risk of cognitive impairment than the direct oral anticoagulant (DOAC) [13,14].…”

Section: Introductionmentioning

confidence: 99%

Protective Effect of Rivaroxaban Against Amyloid Pathology and Neuroinflammation Through Inhibiting PAR-1 and PAR-2 in Alzheimer’s Disease Mice

Bian

Liu

Tian

et al. 2022

JAD

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Background: Recent studies have revealed that atrial fibrillation (AF) patients have a high risk of developing cognitive impairment, vascular dementia, and Alzheimer’s disease (AD). Some reports suggest that the application of oral anticoagulant with an appropriate dose may have a preventive effect on AD. However, which oral anticoagulant drug is more appropriate for preventing AD and the underlying mechanism(s) is still unknown. Objective: The aim of the present study was to assess the treatment effect of rivaroxaban administration as well as investigate the roles of PAR-1 and PAR-2 in the AD + CAA mice model. Methods: In the present study, we compared a traditional oral anticoagulant, warfarin, and a direct oral anticoagulant (DOAC), rivaroxaban, via long-term administration to an AD with cerebral amyloid angiopathy (CAA) mice model. Results: Rivaroxaban treatment attenuated neuroinflammation, blood-brain barrier dysfunction, memory deficits, and amyloid-β deposition through PAR-1/PAR-2 inhibition in the AD + CAA mice model compared with warfarin and no-treatment groups. Conclusion: The present study demonstrates that rivaroxaban can attenuate AD progress and can be a potential choice to prevent AD.

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Comparison of potential pharmacokinetic drug interactions in patients with atrial fibrillation and changing from warfarin to non-vitamin K oral anticoagulant therapy

Cited by 2 publications

References 38 publications

Oral anticoagulant switching in patients with atrial fibrillation: a scoping review

Oral anticoagulant switching in patients with atrial fibrillation: a scoping review

Protective Effect of Rivaroxaban Against Amyloid Pathology and Neuroinflammation Through Inhibiting PAR-1 and PAR-2 in Alzheimer’s Disease Mice

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