{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T11:59:50Z","timestamp":1780055990646,"version":"3.54.0"},"reference-count":40,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>There are emerging concerns from case reports and pharmacovigilance analyses of a possible risk of interstitial lung disease (ILD) associated with the use of factor Xa (FXa) inhibitors.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate the risk of incident ILD associated with the use of oral anticoagulants (OACs) in patients with nonvalvular atrial fibrillation (NVAF).<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This nationwide retrospective cohort study used data from the Taiwan National Health Insurance Research Database. Patients with NVAF without preexisting lung disease who received OACs from June 1, 2012, to December 31, 2017, were included. Propensity score stabilized weighting (PSSW) was used to balance covariates across the medication groups (FXa inhibitors, dabigatran, and warfarin, with warfarin as the reference). Patients were followed up from the drug index date until the onset of ILD, death, or end of the study (December 31, 2019), whichever occurred first. Data were analyzed from September 11, 2021, to August 3, 2022.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Patients with NVAF were treated with FXa inhibitors, dabigatran, or warfarin.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>New-onset idiopathic ILD.<\/jats:p><\/jats:sec>Results<\/jats:title>Among the 106\u202f044 patients (mean [SD] age, 73.4 [11.9] years; 59 995 men [56.6%]) included in the study, 64\u202f555 (60.9%) received FXa inhibitors (apixban [n\u2009=\u200915\u202f386], edoxaban [n\u2009=\u200912\u202f413], and rivaroxaban [n\u2009=\u200936\u202f756]), 22\u202f501 (21.2%) received dabigatran, and 18\u202f988 (17.9%) received warfarin at baseline. The FXa inhibitors were associated with a higher risk of incident ILD (0.29 vs 0.17 per 100 patient-years; hazard ratio, 1.54 [95% CI, 1.22-1.94]; P<\/jats:italic>\u2009&amp;lt;\u2009.001), whereas dabigatran was associated with a nonsignificant difference in risk of incident ILD compared with warfarin (reference) after PSSW. The higher risk of incident ILD for FXa inhibitors vs warfarin was consistent with several high-risk subgroups.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>Results of this study suggest that FXa inhibitors were associated with lung injury among patients with NVAF who were treated with OACs. Physicians should be vigilant in monitoring for any potential adverse lung outcomes associated with the use of these drugs.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.43307","type":"journal-article","created":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T16:00:37Z","timestamp":1669132837000},"page":"e2243307","source":"Crossref","is-referenced-by-count":8,"title":["Development of Interstitial Lung Disease Among Patients With Atrial Fibrillation Receiving Oral Anticoagulants in Taiwan"],"prefix":"10.1001","volume":"5","author":[{"given":"Yi-Hsin","family":"Chan","sequence":"first","affiliation":[{"name":"Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan City, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan City, Taiwan"},{"name":"Microscopy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze-Fan","family":"Chao","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei City, Taiwan"},{"name":"Institute of Clinical Medicine, Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao-Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"College of Medicine, Chang Gung University, Taoyuan City, Taiwan"},{"name":"Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, Taoyuan City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin-Fu","family":"Lee","sequence":"additional","affiliation":[{"name":"College of Medicine, Chang Gung University, Taoyuan City, Taiwan"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan"},{"name":"New Taipei City Municipal Tucheng Hospital, Chang Gung Memorial Hospital, Tucheng Branch, New Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Min","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Medicine, Chang Gung University, Taoyuan City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Ru","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Medicine, Chang Gung University, Taoyuan City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yung-Hsin","family":"Yeh","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan City, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Tai","family":"Kuo","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan City, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lai-Chu","family":"See","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Medicine, Chang Gung University, Taoyuan City, Taiwan"},{"name":"Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan City, Taiwan"},{"name":"Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. 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