Edoxaban Effective for Treating Atrial Fibrillation

Atrial fibrillation may have a safer treatment alternative in edoxaban

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Atrial fibrillation (A-fib) is one of the most common heart rhythm disorders. Doctors are always looking for better ways to treat this common affliction, and edoxaban may be a promising alternative.

Researchers looked at more than 21,000 patients with medium to severe A-fib and placed them in one of three groups. Each group tested the effectiveness and safety of both high and low doses of edoxaban and warfarin.

Edoxaban is marketed under the brand name Lixiana.

This study suggested that edoxaban may be associated with fewer bleeding episodes than warfarin, as well as fewer episodes of stroke and blood clots.

Edoxaban is expected to cause fewer potentially harmful interactions with foods and other medications, and may not require regular lab monitoring when prescribed.

"Control your A-fib symptoms by following your doctors directions closely."

This research team was led by Robert P. Giugliano, PhD, Associate Professor of Medicine at Harvard Medical School and Brigham and Women's Hospital Department of Medicine.

Dr. Giugliano and colleagues studied 21,105 medium to severe A-fib patients over the age of 21. Patients in this study were diagnosed with medium to high levels of A-fib.

Patients were randomly assigned to one of three test groups. One group received warfarin and the other groups received either high (60 mg) or low (30 mg) doses of edoxaban. Neither the researchers nor the patients knew what medication was administered, and to further prevent bias, all patients received both medications in alternating periods throughout the trial.

Patients were enrolled from November 2008 through November 2010 at 1,393 centers across 46 countries, including the United States, Canada, China and France.

The goal of this research was to determine that edoxaban was no less effective than warfarin when used to treat medium to severe A-fib.

Over the course of the study, 232 patients in the warfarin group had a stroke or blood clot obstruction. Of the edoxaban groups, 182 patients of the patients receiving high doses and 253 of the patients receiving low doses experienced stroke or blood clot obstruction.

In this trial, both high and low dose edoxaban performed no worse than warfarin. Edoxaban was associated with lower rates of bleeding relative to the dose administered.

Edoxaban may not require routine laboratory monitoring and could have fewer adverse interactions with foods and other medications, according to the researchers.

This article was published on November 19 in The New England Journal of Medicine.

This study was supported by Daiichi Sankyo Pharma Development. Dr. Giugliano disclosed financial ties with Daiichi Sankyo and other pharmaceutical companies. Several other co-authors disclosed potential conflicts of interests with a number of pharmaceutical companies.

Review Date: 
November 20, 2013
Last Updated:
December 30, 2013