Increasing Very Low-Dose Edoxaban Prescription: Effectiveness and Safety Data of Korean AF Patients
- Author:
JungMin CHOI
1
;
So-Young YANG
;
So-Ryoung LEE
;
Min Soo CHO
;
Kyung-Yeon LEE
;
Hyo-Jeong AHN
;
Soonil KWON
;
Myung-Jin CHA
;
Jun KIM
;
Gi-Byoung NAM
;
Kee-Joon CHOI
;
Eue-Keun CHOI
;
Seil OH
;
Gregory Y. H. LIP
Author Information
- Publication Type:Original Research
- From:Korean Circulation Journal 2025;55(3):215-227
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background and Objectives:Evidence remains limited on the real-world prescription of very low-dose oral anticoagulation among frail patients with atrial fibrillation (AF). We described the practice patterns, effectiveness, and safety of very low-dose edoxaban (15 mg once daily).
Methods:Patients with AF prescribed edoxaban 15 mg once daily in 2 tertiary hospitals between 2016 and September 2022 were included. Baseline clinical characteristics and clinical outcomes of interest were thromboembolic and bleeding events.
Results:A total of 674 patients were included (mean age 78.3±9.1, 49.7% aged ≥80 years, 49.3% women, median follow-up 1.0±1.2 years). Mean CHA 2 DS 2 -VASc score was 3.9±1.6, and the modified HAS-BLED score was 2.0±1.1. Between 2016 and 2022, the number of very lowdose edoxaban prescriptions increased. The main reasons for the prescription of very lowdose were low body weight (55.5% below 60 kg), anaemia (62.8%), chronic kidney disease (40.2%), active cancer (15.3%), concomitant anti-platelet use (26.7%), and prior major bleeding (19.7%). During a median follow-up duration of 8 (interquartile range 3–16) months, overall thromboembolic and bleeding events occurred in 16 (2.3%) and 88 (13.1%) patients, respectively. Compared to the expected event rates on the established risk scoring systems, patients receiving very low-dose edoxaban demonstrated a 61% reduction in ischemic stroke, a 68% reduction of ischemic stroke/transient ischemic attack/systemic embolism, whereas a 49% increase in major bleeding.
Conclusions:The prescription of very low-dose edoxaban was increased over time, attributable to various clinical factors. The use of very low-dose edoxaban reduced the expected risk of thromboembolic events.
