Gastrointestinal bleeding for new users of rivaroxaban

TUESDAY October 12, 2021 (HealthDay News) – Rivaroxaban is associated with increased rates of gastrointestinal bleeding (GIB) compared to other direct oral anticoagulants, according to a study published online Oct. 12 in the Annals of Internal Medicine.

Arnar B. Ingason, MD, University of Iceland Reykjavík, and colleagues compared GIB levels among new users of apixaban, dabigatran, and rivaroxaban from 2014 to 2019. Data was included for 2,157 patients receiving apixaban, 494 receiving dabigatran, and 3,217 receiving rivaroxaban.

The researchers found that, compared to apixaban, rivaroxaban had higher overall levels of GIB in all patients (3.2 versus 2.5 events per 100 person-years; risk ratio, 1.42; 95% confidence interval, 1.04 to 1.93) and higher rates of major GIB (1.9 versus 1.4 events per 100 person-years; hazard ratio, 1.50; 95%, 1.00 to 2.24). Higher GIB levels were also observed for rivaroxaban compared to dabigatran, with similar point estimates, although the confidence intervals were wider, including the possibility of a null event. Compared to apixaban or dabigatran, rivaroxaban had higher levels of overall GIB when only patients with atrial fibrillation were included (risk reports [95 percent confidence intervals], 1.40 [1.01 to 1.94] and 2.04 [1.17 to 3.55], respectively). In both analyzes, dabigatran was associated with lower levels of superior GIB compared to rivaroxaban. “Rivaroxaban was associated with higher levels of GIB than apixaban and dabigatran,” write the authors. “This may help guide the selection of oral anticoagulants, especially for patients at high risk for GIB. ”

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