Meta-analysis of Stroke Efficacy and Bleeding Risk of Edoxaban versus Warfarin in the Prevention of Pa-tients with Atrial Fibrillation
10.6039/j.issn.1001-0408.2016.24.23
- VernacularTitle:依度沙班对比华法林预防房颤患者卒中疗效及出血风险的Meta分析
- Author:
Mingyi TENG
;
Yongchuan CHEN
- Publication Type:Journal Article
- Keywords:
Edoxaban;
Atrial fibrillation;
Excessive bleeding;
Stroke;
Meta-analysis
- From:
China Pharmacy
2016;27(24):3385-3388,3389
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To systematically review the effect of stroke efficacy and bleeding risk of edoxaban versus warfarin in the prevention of patients with atrial fibrillation,and provide evidence-based reference for clinical treatment. METHODS:Re-trieved from Cochrane Library,Medline,EMBase,CJFD,Wangfang Database and VIP Database,randomized controlled trials (RCT)about the stroke efficacy and bleeding risk of edoxaban versus warfarin in patients with atrial fibrillation were collected. Me-ta-analysis was performed for the incidences of stoke and excessive hemorrhage by using Rev Man 5.3 software after data extract. RESULTS:Totally 13 RCTs were included,involving 24 950 patients. Results of Meta-analysis showed,compared with warfarin group,there were no significant differences in the incidences of stoke [RR=0.97,95%CI(0.88,1.08),P=0.60] and excessive hem-orrhage [RR=0.84,95%CI(0.59,1.19),P=0.33] in edoxaban group. But the subgroup analysis showed,when daily dose of edoxa-ban was more than 30 mg,the incidence of stroke in edoxaban group was significantly lower than warfarin group [RR=0.84,95%CI(0.72,0.97),P=0.02];when it was 30 mg,the incidence of excessive bleeding in edoxaban group was significantly lower than warfarin group [RR=0.46,95%CI(0.35,0.61),P<0.001],the difference was statistically significant. CONCLUSIONS:Compared with warfarin,higher doses(>30 mg/d)of edoxaban can more effectively prevent the occurrence of stroke and low doses(30 mg/d) can reduce the risk of excessive bleeding.
