创新背景

DOAC用于预防心房纤颤（心跳缓慢或不规则）患者的中风，这种疾病影响着全球超过3300万人。它们最近比以前的标准治疗方法华法林更常见，因为它们不需要那么多的后续监测（这在Covid-19大流行期间尤其有价值），而且副作用风险更低。

创新过程

研究人员的新研究发现，两种最常见的直接口服抗凝药(DOACs)之一阿哌沙班(apixaban)发生胃肠道出血的风险最低，在预防中风和其他副作用方面的效果相似。

在这项新研究中，研究人员比较了四种最常见的DOAC的疗效和副作用风险。他们审查了来自英国、法国、德国和美国的50多万名新DOAC用户的数据，包括281320名阿哌沙班用户、61008名达比加群用户、12722名爱多沙班用户和172176名利伐沙班用户。

他们发现，这四种药物在缺血性中风、脑出血和全因死亡率方面的结果具有可比性，同时他们也确定了胃肠道出血风险的差异，这是DOACs最常见和令人担忧的副作用之一。

研究显示，阿哌沙班明显具有较低的胃肠道出血风险，与其他三种DOAC相比，其风险降低了19-28%。

近年来，直接口服抗凝剂在全世界被开出的处方越来越频繁，但直接比较它们的证据还很有限。研究结果表明，阿哌沙班可能比其他血液稀释剂更可取，因为它的胃肠道出血率较低，中风的发生率相似。

创新关键点

研究显示，阿哌沙班明显具有较低的胃肠道出血风险，与其他三种DOAC相比，其风险降低了19-28%。

创新价值

研究结果表明，阿哌沙班可能比其他血液稀释剂更可取，因为它的胃肠道出血率较低，可更安全地进行使用，并更多地应用于临床。

The innovation found that apixaban had the lowest risk of gastric bleeding while preventing atrial fibrillation

Apixaban, one of the two most common direct oral anticoagulants (DOACs), has the lowest risk of gastrointestinal bleeding and is similarly effective in preventing stroke and other side effects, researchers found in a new study.

In the new study, researchers compared the efficacy and side effect risk of four of the most common DOacs. They reviewed data from more than 500,000 new DOAC users in the UK, France, Germany, and the US, including 281,320 Apixaban users, 61,008 dabigatran users, 12,722 Edoxaban users, and 172,176 rivaroxaban users.

They found comparable results among the four drugs for ischemic stroke, intracerebral hemorrhage, and all-cause mortality, while they also identified differences in the risk of gastrointestinal bleeding, one of the most common and worrisome side effects of DOACs.

Apixaban was shown to have a significantly lower risk of GI bleeding, with a risk reduction of 19 to 28% compared with the other three DOacs.

In recent years, direct oral anticoagulants have been prescribed more frequently around the world, but the evidence to compare them directly is limited. The findings suggest that apixaban may be preferable to other blood thinners because it has a lower rate of gastrointestinal bleeding and a similar rate of stroke.