Comparative Effectiveness of Warfarin and New Anticoagulants
Authors: Robert L. Trowbridge, Kathryn E. Smith
Journal: Annals of Internal Medicine (2013)

Letters16 April 2013Comparative Effectiveness of Warfarin and New AnticoagulantsRobert L. Trowbridge, MD and Kathryn E. Smith, PharmDRobert L. Trowbridge, MDFrom Maine Medical Center, Portland, Maine.Search for more papers by this author and Kathryn E. Smith, PharmDFrom Maine Medical Center, Portland, Maine.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-8-201304160-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read Adam and colleagues' review (1) with interest and appreciate the authors' efforts to determine the relative effectiveness of these novel anticoagulants. However, we believe that the decision to combine the nonwarfarin anticoagulants into a single comparator group severely limits the conclusions of their review.The authors contend that the new oral anticoagulants (NOACs) may be grouped together because they all inhibit a single step in the coagulation cascade, a mechanism distinct from that of warfarin. However, NOACs vary greatly in structure, function, elimination, and other characteristics within and among the subclasses of factor Xa inhibitors ...References1. Adam SS, McDuffie JR, Ortel TL, Williams JW. Comparative effectiveness of warfarin and new oral anticoagulants for the management of atrial fibrillation and venous thromboembolism: a systematic review. Ann Intern Med. 2012;157:796-807. [PMID: 22928173] LinkGoogle Scholar2. Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, et al; RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139-51. [PMID: 19717844] CrossrefMedlineGoogle Scholar3. Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, et al; ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981-92. [PMID: 21870978] CrossrefMedlineGoogle Scholar4. Patel MR, Mahaffey KW, Garg J, Pan G, Singer DE, Hacke W, et al; ROCKET AF Investigators. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883-91. [PMID: 21830957] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Robert L. Trowbridge, MD; Kathryn E. Smith, PharmDAffiliations: From Maine Medical Center, Portland, Maine.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparative Effectiveness of Warfarin and New Oral Anticoagulants for the Management of Atrial Fibrillation and Venous Thromboembolism Soheir S. Adam , Jennifer R. McDuffie , Thomas L. Ortel , and John W. Williams Jr. Comparative Effectiveness of Warfarin and New Anticoagulants James A. Reiffel Comparative Effectiveness of Warfarin and New Anticoagulants Soheir S. Adam , Thomas L. Ortel , and John W. Williams Jr. Metrics 16 April 2013Volume 158, Issue 8Page: 636-637KeywordsAnticoagulantsApixabanErythromycinGastrointestinal hemorrhageMortalityPenicillinPopulation statisticsProtein synthesisSafetyThrombin ePublished: 16 April 2013 Issue Published: 16 April 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...