A low dose of the anticoagulant edoxaban safely and effectively prevents stroke and blood clots in elderly patients with atrial fibrillation, a late-stage drug trial has found.

Investigators followed Japanese participants 80 years of age or older with nonvalvular atrial fibrillation who were at high risk of bleeding from standard anticoagulant doses. The 984 patients received a relatively low, 15 mg daily dose of either edoxaban (Savaysa) or a placebo. 

Participants in the edoxaban group experienced stroke or systemic embolism at a rate of 2.3% compared with 6.7% in the placebo group. The rate of major gastrointestinal bleeding was substantially higher — at  3.3% — in the medication group than in the placebo group (1.8%), but the difference was not statistically significant, the researchers said. There was no difference between the groups for death from any cause, reported Ken Okumura, M.D., Ph.D., from Saiseikai Kumamoto Hospital, Kumamoto, Japan.

The study was published in the New England Journal of Medicine.