Rational Pharmacotherapy in Cardiology

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Large randomized clinical trials (RCTs) in patients with non-valvular atrial fibrillation (AF) showed that new direct oral anticoagulants (DOACs) were just as effective at preventing stroke and systemic thromboembolic (STE) complications as warfarin, although DOACs were associated with less risk of intracranial bleeding. There was significant increasing number of publications addressed to use of DOACs in real-world setting in recent years. We discussed some of pros and cons for studies used real-world data in the review. Results of real-world studies provided a generally strong support for conclusions of main RCTs. In comparison of different DOACs against each other apixaban demonstrated lower bleeding risk while patients given rivaroxaban appeared to have higher rate of hemorrhagic events. High adherence to apixaban treatment for AF irrespective to additional value educational program suggested that apixaban treatment is easy to follow and well accepted by patients despite of twice-daily dosing regimen. Healthcare cost analyses demonstrated that patients who were prescribed apixaban had lower stroke/STE-related as well as major bleeding-related medical costs.

About the Authors

Zh. D. Kobalava
Peoples' Friendship University of Russia (RUDN University)
Russian Federation

Zhanna D. Kobalava – MD, PhD, Professor, Head of Chair of Internal Medicine with Course of Cardiology and Functional Diagnostics, Head of Chair of Internal Medicine, Cardiology and Functional Diagnostics of the Faculty of Advanced Training of Medical Workers, Medical Institute

Miklukho-Maklaya ul. 6, Moscow, 117198

S. V. Villevalde
Peoples' Friendship University of Russia (RUDN University)
Russian Federation

Svetlana V. Villevalde – MD, PhD, Professor, Chair of Internal Medicine with Course of Cardiology and Functional Diagnostics, Medical Institute

Miklukho-Maklaya ul. 6, Moscow, 117198

A. A. Shavarov
Peoples' Friendship University of Russia (RUDN University)
Russian Federation

Andrey A. Shavarov – MD, PhD, Associate Professor, Chair of Internal Medicine with Course of Cardiology and Functional Diagnostics

Miklukho-Maklaya ul. 6, Moscow, 117198


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For citations:

Kobalava Z.D., Villevalde S.V., Shavarov A.A. NEW DIRECT ORAL ANTICOAGULANTS FOR TREATMENT OF PATIENTS WITH ATRIAL FIBRILLATION IN REAL-WORLD SETTING. Rational Pharmacotherapy in Cardiology. 2018;14(2):298-305. (In Russ.)

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