Real World Analysis of Effectiveness and Safety of Apixaban Versus Warfarin in Obese Patients with Nonvalvular Atrial Fibrillation- a RWE

As we have seen so far Real-world studies have evaluated the use of anticoagulants in obese patients with nonvalvular atrial fibrillation (NVAF), but they have been limited by sample size or the use of diagnosis codes on claims to define obesity. In a retrospective study of 26,522 NVAF patients with body weight of ≥100 kg or a body mass index of ≥30 kg/m2 , were enrolled from Veterans Affairs and fee-for-service Medicare system. The study evaluated the risk of stroke/systemic embolism (SE) and major bleeding (MB) in patients that were initiated on apixaban or  warfarin. After randomization 13,604 of NVAF population were on  apixaban and 12,918 were on warfarin Their  mean age was 75 years, 98% male, the mean CHA2DS2-VASc score was 3.8, and the mean HAS-BLED Score was ∼2.6 It was found that apixaban patients were associated with a similar risk of stroke/ systemic embolism (hazard ratio: 0.82) and a significantly lower risk of major bleeding MB (hazard ratio: 0.62) versus warfarin. No significant interaction was observed between treatment and obesity status for stroke/SE (p value of interaction of 0.602) or major bleeding (p value of interaction of  0.385). The study concluded that in obese patients with NVAF, apixaban was associated with a similar risk of stroke/ systemic embolism and a significantly lower risk of major bleeding versus warfarin. Disclaimer: Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STAR UPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.