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MONDAY, May 18, 2020 (HealthDay News) — For patients with atrial fibrillation (AF), the risk for osteoporotic fracture appears to be lower with direct oral anticoagulant (DOAC) use compared with warfarin use, according to a study published online May 19 in the Annals of Internal Medicine<\/i>.<\/p>\n
Wallis C.Y. Lau, Ph.D., from the University College London School of Pharmacy, and colleagues compared the risk for osteoporotic fracture between anticoagulants in a population-based cohort study. Patients newly diagnosed with AF between 2010 and 2017 who received a new prescription for warfarin or a DOAC were included and followed through Dec. 31, 2018. Data were included for 23,515 patients: 3,241 apixaban users, 6,867 dabigatran users, 3,866 rivaroxaban users, and 9,541 warfarin users.<\/p>\n
The researchers identified 401 fractures during a median follow-up of 423 days (crude event number [weighted rate per 100 patient-years]: apixaban, 53; dabigatran, 95; rivaroxaban, 57; warfarin, 196). DOAC use was associated with a lower fracture risk than warfarin use after 24-month follow-up (apixaban cumulative incidence difference [CID], \u22120.88 percent; dabigatran CID, \u22120.81 percent; rivaroxaban CID, \u22121.13 percent). In head-to-head comparisons between DOACs at 24 months, there were no differences observed.<\/p>\n
“These findings may help inform the benefit-risk assessment when choosing between anticoagulants,” the authors write.<\/p>\n