Cerebral hemorrhage

The blood thinner apixaban (Eliquis) is safe and effective in stroke patients and may present fewer risks than warfarin, according to a secondary analysis.

The drug is associated with less bleeding, death and hospitalization than warfarin, regardless of prior stroke history or blood clots, reported investigators.

The finding comes as more clinicians choose to treat nursing home residents with anticoagulants. Meanwhile, direct oral anticoagulants like apixaban are rivaling the use of vitamin k agonists such as warfarin in these settings, according to recent research.

“Increases in anticoagulant use among U.S. nursing home residents with atrial fibrillation [has] coincided with declining warfarin use and increasing DOAC use,” wrote Matthew Alcusky, Ph.D., PharmD, from University of Massachusetts Medical School.

Clinicians’ increased comfort level with direct oral anticoagulants is in part due to the availability of reversal agents. These medications quickly allow normal coagulation in the event of accident or need for emergency surgery, Alcusky and colleagues explained. 

The new analysis of apixaban follows the successful AUGUSTUS trial, published in early 2019. A generic for the drug was recently approved by the FDA.  

These latest findings were presented Friday at the American Stroke Association’s International Stroke Conference 2020.