## 5 Conclusions  
In this ETNA-AF-Europe analysis, edoxaban seemed associated with a very low occurrence of stroke and bleeding, independently of the weight category in this wide European prospective observational study. A higher risk of death due to any cause was observed in lower and higher weight patients compared with the intermediate weight patients (reference weight category) after adjustment for important risk modifiers. This finding is in contrast with studies that described an \"obesity paradox\" for mortality. The data available thus far have also shown that the obesity paradox is not evident after statistical adjustments for associated comorbidities such as old age. Findings from ETNA-AF-Europe suggest that patients with low body weight do well with a dose reduction. Moreover, the data also suggest that in overweight and obese patients, standard doses are adequate to achieve improved outcomes. To conclude, patients at extremes of body weight reported low rates of stroke and bleeding events with edoxaban within the current dosing guidelines. **Supplementary Materials:** The following are available online at [[https://www.mdpi.com/article/10.3390/jcm10132879/s1](https://www.mdpi.com/article/10.3390/jcm10132879/s1)]([https://www.mdpi.com/article/10.3390/jcm10132879/s1](https://www.mdpi.com/article/10.3390/jcm10132879/s1)), Table S1: Baseline demographics and clinical characteristics of patients included in ETNA-AF-Europe according to additional body weight categories, Table S2: Baseline demographics and clinical characteristics of patients included in ETNA-AF-Europe categorised by BMI, Table S3: Outcomes at 1 year split by gender for weight categories (unadjusted data), Table S4: Outcomes at 1 year split by gender for weight categories (adjusted for eGFR and CHA\({}_{2}\)DS\({}_{2}\)-VASc), Table S5: Outcomes at 1-year categorised by BMI (unadjusted data), 6: Outcomes at 1-year categorised by BMI (adjusted for eGFR and CHA\({}_{2}\)DS\({}_{2}\)-VASc), Table S7: Outcomes at 1-year split by gender for BMI categories (unadjusted data), Table S8: Outcomes at 1-year split by gender for BMI categories (adjusted for eGFR and CHA\({}_{2}\)DS\({}_{2}\)-VASc), Figure S1: Frequency of patients (split by male and female) across the range of body weight at baseline, Figure S2: Frequency of patients across the range of BMI at baseline, Figure S3: Frequency of patients (split by male and female) across the range of BMI at baseline. **Author Contributions:** All authors made substantial contributions to drafting the work or substantively revising it; approved the submitted version; agreed to be personally accountable for their own contributions and for ensuring that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and documented in the literature. Conceptualization, G.B., R.D.C. and P.K. ; Methodology, L.P., G.B., M.C.M. and J.S. ; Software, Validation, Formal Analysis, L.P.; Investigation, G.B., R.D.C. and P.K. ; Resources, M.C.M. and J.S. ; Data Curation, L.P., M.C.M. and J.S. ; Writing-Original Draft Preparation, G.B. ; Writing-Review & Editing, All; Visualization, G.B. and L.P.; Supervision, G.B., R.D.C.and P.K. ; Project Administration, M.C.M. All authors have read and agreed to the published version of the manuscript. **Funding:** This study was funded by Daiichi Sankyo Europe GmbH, Munich, Germany. **Institutional Review Board Statement:** The study was approved by the institutional review boards and Independent Ethics Committees for all participating centres in compliance with the Declaration of Helsinki and Guidelines for Good Pharmacoepidemiological Practice (GPP). **Informed Consent Statement:** All participants provided written informed consent. **Data Availability Statement:** The data underlying this article are available in the article and in its online Supplementary material. **Acknowledgments:** This study was funded by Daiichi Sankyo Europe GmbH, Munich, Germany.