Most Read Articles
Roshini Claire Anthony, 29 May 2020

For coffee drinkers, drinking filtered coffee may be tied to a lower mortality risk, including cardiovascular disease (CVD)-related mortality, a study from Norway suggested.

3 days ago
Use of metformin is effective in preventing hyperglycaemia in nondiabetic cancer patients exposed to high-dose prednisone-based chemotherapy, results of a randomized study have shown.
6 days ago
Use of corticosteroid is not associated with improved outcomes in idiopathic pulmonary fibrosis (IPF) patients admitted to the hospital with acute exacerbation (AE), reveals a recent study. In addition, corticosteroids may even contribute to reduced overall survival following exacerbation.
Dr. Wong Soon Tee, 28 May 2020
Acne is a common skin problem seen in primary care. Dr Wong Soon Tee of Assurance Skin Clinic at Mt Elizabeth Novena Hospital, Singapore shares his insights with Pearl Toh on how to manage acne in the primary care setting.

High-dose edoxaban as effective as, but safer than, warfarin for atrial fibrillation

28 Mar 2020

Edoxaban affords greater treatment safety than warfarin, while delivering comparable efficacy, in patients with atrial fibrillation (AF), irrespective of diabetes, a recent study has found.

Drawing from the ENGAGE AF-TIMI 48* trial, researchers identified 7,624 patients (median age, 70 years; 36.5 percent female) with diabetes and 13,481 (median age, 73 years; 39.0 percent female) without. The principal efficacy outcome was a composite of stroke and systemic embolic events (SEE), while safety was assessed as major bleeding.

A high-dose edoxaban regimen performed comparably to warfarin. Annualized rates of the primary efficacy outcome did not differ between treatment in those with (1.42 percent vs 1.5 percent; hazard ratio [HR], 0.93, 95 percent confidence interval [CI], 0.71–1.23) and without (1.65 percent vs 1.96 percent; HR, 0.84, 95 percent CI, 0.70–1.02) diabetes.

However, edoxaban, at high doses, demonstrated better safety than warfarin. Major bleeding occurred significantly less frequently in the former treatment arm than in the latter, both in patients with (3.20 percent vs 4.07 percent per year; HR, 0.79, 95 percent CI, 0.65–0.96) and without (2.68 percent vs 3.30 percent; HR, 0.81, 95 percent CI, 0.69–0.96) diabetes.

Stratification according to the use of insulin did not meaningfully alter the findings, and the effects of a low-dose edoxaban regimen did not appear to be modified by diabetes status.

“Since patients with insulin treated diabetes and AF are at higher risk for both stroke and bleeding, use of safer, yet effective, oral anticoagulants, such as edoxaban, may be preferred over [vitamin K antagonists],” said the researchers.

*Effective anticoagulation with factor Xa next generation in atrial fibrillation–thrombolysis in myocardial infarction study 48

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Roshini Claire Anthony, 29 May 2020

For coffee drinkers, drinking filtered coffee may be tied to a lower mortality risk, including cardiovascular disease (CVD)-related mortality, a study from Norway suggested.

3 days ago
Use of metformin is effective in preventing hyperglycaemia in nondiabetic cancer patients exposed to high-dose prednisone-based chemotherapy, results of a randomized study have shown.
6 days ago
Use of corticosteroid is not associated with improved outcomes in idiopathic pulmonary fibrosis (IPF) patients admitted to the hospital with acute exacerbation (AE), reveals a recent study. In addition, corticosteroids may even contribute to reduced overall survival following exacerbation.
Dr. Wong Soon Tee, 28 May 2020
Acne is a common skin problem seen in primary care. Dr Wong Soon Tee of Assurance Skin Clinic at Mt Elizabeth Novena Hospital, Singapore shares his insights with Pearl Toh on how to manage acne in the primary care setting.