Direct comparison of dabigatran, rivaroxaban, and apixaban for effectiveness and safety in non-valvular atrial fibrillation
Peter A. Noseworthy, MD; Xiaoxi Yao, PhD; Neena S. Abraham, MD, MSCE; Lindsey R. Sangaralingham, MPH; Robert D. McBane, MD; Nilay D. Shah, PhD Abstract Background The introduction of non-vitamin K antagonist oral anticoagulants (NOACs) has been a major advance for stroke prevention in atrial fibrillation (AF). Patients and clinicians now have a choice between different NOACs, but have no direct comparative effectiveness evidence to guide decision-making. We aimed to compare the effectiveness and safety of dabigatran, rivaroxaban, and apixaban in clinical practice. Methods Using a large U.S. administrative claims database, we created three one-to-one propensity-score matched cohorts of patients with non-valvular AF who were users of dabigatran, rivaroxaban, or apixaban between 10/1/2010-2/28/2015 (Rivaroxaban versus dabigatran [N=31,574]; apixaban versus dabigatran [N=13,084] and apixaban...