Warfarin, Rivaroxaban Similarly Safe, Effective
TUESDAY, Sept. 12, 2017 -- For cases of mild atrial fibrillation (AF)-related acute ischemic stroke, rivaroxaban and warfarin are similarly safe and effective at preventing recurrent stroke, according to a study published online Sept. 11 in JAMA Neurology.
Keun-Sik Hong, M.D., from Inje University in Goyang, South Korea, and colleagues compared rivaroxaban or warfarin sodium for prevention of early recurrent stroke in patients with AF-related acute ischemic stroke. Patients were randomized (1:1) to receive rivaroxaban (10 mg/day for five days followed by 15 or 20 mg/day; 95 participants) or warfarin with a target international normalized ratio of 2.0 to 3.0 (88 participants), for four weeks.
The researchers found that the two groups showed no differences in the primary composite end point (P = 0.49) or its individual components: new ischemic lesion (relative risk [RR], 0.83; 95 percent confidence interval, 0.54 to 1.26; P = 0.38) or new intracranial hemorrhage (RR, 1.10; 95 percent confidence interval, 0.70 to 1.71; P = 0.68). Each group had one clinical ischemic stroke. All new intracranial hemorrhages were asymptomatic hemorrhagic transformations. Rivaroxaban was associated with reduced hospitalization length compared with warfarin (median, 4.0 days versus 6.0 days; P < 0.001).
"In mild AF-related acute ischemic stroke, rivaroxaban and warfarin had comparable safety and efficacy," the authors write.
Several authors disclosed financial ties to pharmaceutical companies, including Bayer, which partially funded the study.
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Posted: September 2017