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Introduction: The risk of gastrointestinal (GI) bleeding of dabigatran and rivaroxaban is relatively unexplored. The aim of our study was to compare this risk in both drugs.
Methods: We examined the medical records of patients on either dabigatran or rivaroxaban from October 2010 to April 2013 in two hospitals.
Results: A total of 374 patients (147 rivaroxaban vs. 227 dabigatran) were identified. GI bleeding occurred in 5.3% in the dabigatran when compared to 4.8% in the rivaroxaban group (p = 0.8215). Multivariate analysis showed that the odds of GI bleeding while on dabigatran for ≤40 days when compared to ≥40 days was 8.3 (p < 0.0001). In the rivaroxaban group, patients who were on the drug for ≤40 days had a higher incidence of bleeding when compared to those >40 days (OR = 2.8, p = 0.023). Concomitant use of antiplatelets (single or dual) or non-steroidal anti-inflammatory drugs was not associated with increased bleeding in the dabigatran group; however, the use of dual antiplatelet agents with rivaroxaban was associated with an increased risk of GI bleeding (OR = 7.4, p = 0.0378). Prior GI bleeding had a higher risk of bleeding in the rivaroxaban group (OR = 15.5, p = 0.0002).
Conclusion: Dabigatran was not associated with a higher incidence of GI bleeding. Both drugs had a higher bleeding risk in the first 40 days.
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http://dx.doi.org/10.1159/000365967 | DOI Listing |
Eur J Clin Invest
September 2025
Liverpool Centre for Cardiovascular Science, at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK.
Background: Patients with atrial fibrillation (AF) with end-stage renal failure on renal replacement therapy are at high risk of stroke and bleeding, but the optimal oral anticoagulation (OAC) strategy is uncertain. To investigate the most effective OAC therapy for patients with AF on long-term dialysis.
Methods: PubMed, EMBASE and Web of Science databases were systematically searched from inception to 9 October 2024 to identify relevant studies on OAC strategy for patients with AF on long-term dialysis.
J Pharm Policy Pract
September 2025
Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.
Background: The use of new oral anticoagulants (NOACs) is becoming increasingly widespread, but data on their adverse reactions are still incomplete. Further analysis based on data from the Drug Adverse Reaction Center is needed to guide safe clinical use.
Methods: A retrospective analysis was performed on 281 cases of rivaroxaban and 48 cases of dabigatran etexilate-related ADR reported by medical institutions collected by a provincial Food and Drug Administration from 2018 to 2023.
Clin Ther
September 2025
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. Electronic address:
Purpose: Despite their promising safety profile, use of direct oral anticoagulants (DOACs) presents challenges, particularly concerning polypharmacy and potential drug-drug interactions (DDIs). This study aimed to investigate real-world effects of polypharmacy and DDIs among DOAC users, focusing on patients with atrial fibrillation (AF).
Methods: A retrospective cohort analysis was conducted using administrative health care data from the Caserta Local Health Unit (2012-2020).
Life (Basel)
August 2025
Department of Cardiology, St. Vincent's Hospital, The Catholic University of Korea, Seoul 16247, Republic of Korea.
(1) Background: Atrial fibrillation (AF) is the most common arrhythmia and poses a clinical dilemma in the very elderly due to increased thromboembolic and bleeding risks. This study aimed to evaluate clinical outcomes-including thromboembolic events, major bleeding, and all-cause mortality-by age group in elderly East Asian patients with non-valvular AF receiving oral anticoagulants. (2) Methods: This retrospective single-center study included 502 patients aged ≥70 years treated with direct oral anticoagulants (DOACs: dabigatran, rivaroxaban, edoxaban, or apixaban) or warfarin between 2016 and 2024.
View Article and Find Full Text PDFJ Thromb Thrombolysis
August 2025
Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, Rome, 00161, Italy.
Data on direct oral anticoagulants (DOACs) in venous thrombotic antiphospholipid antibody syndrome (APS) are controversial. This pilot study aimed to assess the safety and efficacy of DOACs in APS patients requiring oral anticoagulation for venous thromboembolism (VTE) but unsuitable for treatment with vitamin K antagonists (VKAs). We performed a prospective multi-centre case-series including APS patients with previous VTE who were receiving treatment with DOACs due to ineligibility for VKAs.
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