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This retrospective study was conducted to compare the stroke\/SE and MB risks between patients switched from warfarin to apixaban, dabigatran, or rivaroxaban in real-world clinical practice.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>This study used data from four United States commercial claims databases from January 1, 2012 to June 30, 2019. The study population included NVAF patients initially treated with warfarin and switched to apixaban, dabigatran, or rivaroxaban within 90 days of their warfarin prescription ending. Patients were matched 1:1 between the DOACs in each database using propensity scores and then pooled for the final analysis. Cox proportional hazards models were used to calculate the risk of stroke\/SE and MB.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results and conclusions<\/jats:title>\n                <jats:p>The final population consisted of 2,611 apixaban-dabigatran, 12,165 apixaban-rivaroxaban, and 2,672 dabigatran-rivaroxaban pairs. Apixaban vs. dabigatran was associated with a lower risk of stroke\/SE (hazard ratio [HR]: 0.61; 95% confidence interval [CI]: 0.39\u20130.96) and MB (HR: 0.67; 95% CI: 0.50\u20130.91). Apixaban vs. rivaroxaban was associated with a similar risk of stroke\/SE (HR: 0.88; 95% CI: 0.73\u20131.07) and a lower risk of MB (HR: 0.60; 95% CI: 0.52\u20130.68). There was no significant difference in either risk between dabigatran and rivaroxaban. These results provide important insights into how the risks of stroke\/SE and MB for NVAF patients vary when switching from warfarin to different DOACs.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11239-024-02976-1","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T20:27:28Z","timestamp":1714681648000},"page":"1092-1102","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effectiveness and safety in non-valvular atrial fibrillation patients switching from warfarin to direct oral anticoagulants in US healthcare claims"],"prefix":"10.1007","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. 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VN and LA are employed by STATinMED, a paid consultant to Pfizer and Bristol Myers Squibb, in connection with the study. AK, NA, SH, DC and JJ are employees of Bristol Myers Squibb, a study sponsor. XL is an employee of Pfizer, a study sponsor.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"N\/A.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"This study was sponsored by the Bristol Myers Squibb-Pfizer Alliance. GYHL and SD received research support from Pfizer and Bristol Myers Squibb. VA and LA are employed by STATinMED, a paid consultant company to Pfizer and Bristol Myers Squibb, in connection with the development of the manuscript. AK, NA, SH, DC and JJ are employees of Bristol Myers Squibb, a study sponsor. XL is an employee of Pfizer, a study sponsor.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}