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- W2912382166 abstract "Purpose: Polypharmacy is associated with frailty and adverse clinical events. Compared with warfarin, apixaban is more efficacious in preventing stroke and safer in patients with atrial fibrillation (AF). However, it has not been shown if these benefits are preserved in patients treated with several concomitant drugs. Methods: All patients included in the ARISTOTLE trial (n=18,201) were divided into tertiles according to the number of drugs used at baseline. The treatment effects of apixaban versus warfarin on clinical outcomes were assessed according to the number of concomitant medications. Results: The median number of concomitant drugs was 6 (IQR 5-9). When comparing tertiles, patients using more drugs were older, more often female, and had more comorbidities than patients using less medications. During a median follow-up of 1.8 years, the rates of efficacy and safety outcomes increased across tertiles. The superiority of apixaban when compared with warfarin in reducing stroke and systemic embolism was consistent regardless of the number of concomitant drugs (interaction p-value= 0.8203; Table). In terms of safety, the magnitude of benefit with apixaban decreased with the number of drugs taken (interaction p-value= 0.0173). A similar treatment effect pattern was seen for the net clinical benefit. Conclusions: In ARISTOTLE, both ischemic and hemorrhagic complications occurred more frequently in patients treated with a higher number of concomitant medications. The benefits of apixaban in reducing stroke were preserved, regardless of the number of drugs taken. In terms of safety and net clinical benefit, while the rates were consistently lower with apixaban, the magnitude of benefit with apixaban decreased with the number of concomitant drugs. Thus, apixaban is a more effective and at least as safe alternative to warfarin in patient with AF with polypharmacy." @default.
- W2912382166 created "2019-02-21" @default.
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- W2912382166 date "2015-11-10" @default.
- W2912382166 modified "2023-09-27" @default.
- W2912382166 title "Abstract 17205: Polypharmacy and the Impact of Apixaban on Clinical Events in Patients With Atrial Fibrillation: Insights From the ARISTOTLE Trial" @default.
- W2912382166 doi "https://doi.org/10.1161/circ.132.suppl_3.17205" @default.
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