New oral anticoagulants

A CMAJ letter1 from a "little cheese" family physician about new oral anticoagulants versus warfarin, and the response2 from three "big cheese" academic specialists show that readers and authors of guidelines do not always agree. The guideline authors note the absence of publishe...

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Bibliographic Details
Published in:Canadian Medical Association journal (CMAJ) 2015-05, Vol.187 (8), p.603-603
Main Authors: Perry, Thomas L, Wright, James M, Mintzes, Barbara, O'Sullivan, Cait, Tejani, Aaron M
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
Antithrombins - therapeutic use
Atrial Fibrillation - drug therapy
Female
Humans
Hypertension - complications
Letters
Stroke - prevention & control
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Summary:A CMAJ letter1 from a "little cheese" family physician about new oral anticoagulants versus warfarin, and the response2 from three "big cheese" academic specialists show that readers and authors of guidelines do not always agree. The guideline authors note the absence of published randomized trials directly comparing the four new anticoagulants, and assure readers that "it is unlikely that any will be conducted in the near future."3 The guideline emphasizes that indirect comparisons between new oral anticoagulants limit our ability to draw inferences on whether any are superior or inferior, and that "any differences in efficacy that might exist among the NOACs [new oral anticoagulants], and even the difference in efficacy between warfarin and each of the NOACs, is very small compared with the reduction of stroke with any OAC [oral anticoagulant] compared with no OAC."
ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.1150037