{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:01:10Z","timestamp":1780531270857,"version":"3.54.1"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100022274","name":"Daiichi Sankyo","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100022274","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TH Open"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Based on efficacy and safety data from randomized controlled trials (RCTs) and real-world studies, direct oral anticoagulants are recommended for thromboembolism prevention in patients with atrial fibrillation (AF). However, no RCTs have compared edoxaban with apixaban.<\/jats:p>\n                  <jats:p>This study aimed to retrospectively compare clinical outcomes for patients with AF in Italy (overall and by age group) who received edoxaban versus apixaban.<\/jats:p>\n                  <jats:p>Adult patients with AF who newly initiated an edoxaban or apixaban prescription between January 2016 and December 2021 were identified from the Italian IQVIA\u00ae Longitudinal Patient Database. Patient characteristics were summarized. Propensity score matching was used to balance baseline characteristics between the edoxaban and apixaban groups. Clinical outcomes of effectiveness (ischemic stroke [IS] or systemic embolism [SE]) and safety (any major bleeding [MB]) were compared. Incidence rates per 100 person-years and hazard ratios (HRs) with 95% CIs were computed.<\/jats:p>\n                  <jats:p>Among 8,444 identified patients, 37.8% (n\u2009=\u20093,188) were prescribed edoxaban and 62.2% (n\u2009=\u20095,256) were prescribed apixaban. After matching, patient characteristics were similar between cohorts. The post-matching risk (HR, 95% CI) of IS\/SE was significantly lower for edoxaban versus apixaban in the overall population (0.78, 0.61\u20130.99; p\u2009=\u20090.04) and in patients aged \u226580 years (0.61, 0.44\u20130.86; p\u2009&lt;\u20090.01), with a similar risk for MB for edoxaban versus apixaban. No significant differences were observed between edoxaban and apixaban among patients aged &lt;80 years (all p\u2009&gt;\u20090.05).<\/jats:p>\n                  <jats:p>IS\/SE risk was significantly lower for edoxaban versus apixaban, without an increased MB risk among patients with AF overall and those aged \u226580 years.<\/jats:p>","DOI":"10.1055\/a-2822-9746","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T23:54:06Z","timestamp":1774310046000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Edoxaban versus Apixaban Outcomes Differences in 8,444 Patients with Atrial Fibrillation from Italy: A Real-World Use Comparison"],"prefix":"10.1055","volume":"10","author":[{"given":"Angel","family":"Valladares","sequence":"additional","affiliation":[{"name":"IQVIA, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Imperato","sequence":"additional","affiliation":[{"name":"IQVIA, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidharth","family":"Gupta","sequence":"additional","affiliation":[{"name":"IQVIA, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Wang","sequence":"additional","affiliation":[{"name":"Daiichi Sankyo Inc., Basking Ridge, New Jersey, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shantanu","family":"Jawla","sequence":"additional","affiliation":[{"name":"Daiichi Sankyo Europe GmbH, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Clasen","sequence":"additional","affiliation":[{"name":"Daiichi Sankyo Inc., Basking Ridge, New Jersey, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"Smolnik","sequence":"additional","affiliation":[{"name":"Daiichi Sankyo Europe GmbH, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Chen","sequence":"additional","affiliation":[{"name":"Daiichi Sankyo Inc., Basking Ridge, New Jersey, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Unverdorben","sequence":"additional","affiliation":[{"name":"Daiichi Sankyo Inc., Basking Ridge, New Jersey, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Ye","sequence":"additional","affiliation":[{"name":"Daiichi Sankyo Inc., Basking Ridge, New Jersey, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5404-3968","authenticated-orcid":false,"given":"Giuseppe","family":"Patti","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale, Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Br\u00fcggenj\u00fcrgen","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Institute for Health Services Research and Technical Orthopedics, Hannover Medical School at DIAKOVERE Annastift Hospital, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"100786","DOI":"10.1016\/j.lanepe.2023.100786","article-title":"Atrial fibrillation: epidemiology, screening and digital health","volume":"37","author":"D Linz","year":"2024","journal-title":"Lancet Reg Health Eur"},{"issue":"10","key":"ref2","doi-asserted-by":"crossref","first-page":"e56","DOI":"10.1161\/CIR.0000000000000659","article-title":"Heart disease and stroke statistics-2019 update: A report from the American Heart Association","volume":"139","author":"E J Benjamin","year":"2019","journal-title":"Circulation"},{"issue":"12","key":"ref3","doi-asserted-by":"crossref","first-page":"e0209687","DOI":"10.1371\/journal.pone.0209687","article-title":"Mortality and causes of death in patients with atrial fibrillation: A nationwide population-based study","volume":"13","author":"E Lee","year":"2018","journal-title":"PLoS ONE"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"213","DOI":"10.2147\/CLEP.S47385","article-title":"Epidemiology of atrial fibrillation: European perspective","volume":"6","author":"M Zoni-Berisso","year":"2014","journal-title":"Clin Epidemiol"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"G Hindricks","year":"2021","journal-title":"Eur Heart J"},{"issue":"10","key":"ref6","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1093\/europace\/euz141","article-title":"Prevalence of atrial fibrillation in the Italian elderly population and projections from 2020 to 2060 for Italy and the European Union: The FAI Project","volume":"21","author":"A Di Carlo","year":"2019","journal-title":"Europace"},{"issue":"12","key":"ref7","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1056\/NEJMoa0905561","article-title":"Dabigatran versus warfarin in patients with atrial fibrillation","volume":"361","author":"S J Connolly","year":"2009","journal-title":"N Engl J Med"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"573","DOI":"10.3390\/jcm10040573","article-title":"Safety and effectiveness of edoxaban in atrial fibrillation patients in routine clinical practice: One-year follow-up from the Global Noninterventional ETNA-AF Program","volume":"10","author":"R De Caterina","year":"2021","journal-title":"J Clin Med"},{"issue":"22","key":"ref9","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1056\/NEJMoa1310907","article-title":"Edoxaban versus warfarin in patients with atrial fibrillation","volume":"369","author":"R P Giugliano","year":"2013","journal-title":"N Engl J Med"},{"issue":"10","key":"ref10","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1056\/NEJMoa1009638","article-title":"Rivaroxaban versus warfarin in nonvalvular atrial fibrillation","volume":"365","author":"M R Patel","year":"2011","journal-title":"N Engl J Med"},{"issue":"11","key":"ref11","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1056\/NEJMoa1107039","article-title":"Apixaban versus warfarin in patients with atrial fibrillation","volume":"365","author":"C B Granger","year":"2011","journal-title":"N Engl J Med"},{"issue":"11","key":"ref16","doi-asserted-by":"crossref","first-page":"3207","DOI":"10.3390\/jcm11113207","article-title":"Five years of direct oral anticoagulants use in Italy: Adverse drug reactions from the Italian National Pharmacovigilance Network","volume":"11","author":"C Lavalle","year":"2022","journal-title":"J Clin Med"},{"issue":"04","key":"ref17","doi-asserted-by":"crossref","first-page":"290","DOI":"10.3390\/ph14040290","article-title":"Comparison of direct oral anticoagulant use for the treatment of non-valvular atrial fibrillation in pivotal clinical trials vs. the real-world setting: A population-based study from Southern Italy","volume":"14","author":"Y Ingrasciotta","year":"2021","journal-title":"Pharmaceuticals (Basel)"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"108785","DOI":"10.4061\/2011\/108785","article-title":"Stroke in the very old: A systematic review of studies on incidence, outcome, and resource use","volume":"2011","author":"T Russo","year":"2011","journal-title":"J Aging Res"},{"issue":"05","key":"ref19","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1093\/europace\/eur126","article-title":"Bleeding risk assessment and management in atrial fibrillation patients: A position document from the European Heart Rhythm Association, endorsed by the European Society of Cardiology Working Group on Thrombosis","volume":"13","author":"G Y Lip","year":"2011","journal-title":"Europace"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"e70091","DOI":"10.1002\/clc.70091","article-title":"Two-year follow-up of patients with atrial fibrillation receiving edoxaban in routine clinical practice: Results from the Global ETNA-AF Program","volume":"48","author":"R De Caterina","year":"2025","journal-title":"Clin Cardiol"},{"issue":"09","key":"ref21","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1001\/jamacardio.2024.1793","article-title":"Dose reduction of edoxaban in patients 80 years and older with atrial fibrillation: Post hoc analysis of the ENGAGE AF-TIMI 48 randomized clinical trial","volume":"9","author":"A Zimerman","year":"2024","journal-title":"JAMA Cardiol"},{"issue":"10","key":"ref22","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1093\/europace\/euab065","article-title":"2021 European Heart Rhythm Association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation","volume":"23","author":"J Steffel","year":"2021","journal-title":"Europace"},{"issue":"22","key":"ref23","doi-asserted-by":"crossref","first-page":"2864","DOI":"10.1001\/jama.285.22.2864","article-title":"Validation of clinical classification schemes for predicting stroke: Results from the National Registry of Atrial Fibrillation","volume":"285","author":"B F Gage","year":"2001","journal-title":"JAMA"},{"issue":"06","key":"ref24","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1002\/pds.2109","article-title":"An automated database case definition for serious bleeding related to oral anticoagulant use","volume":"20","author":"A Cunningham","year":"2011","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.jacasi.2021.11.006","article-title":"Different renal function equations and dosing of direct oral anticoagulants in atrial fibrillation","volume":"2","author":"Y H Chan","year":"2022","journal-title":"JACC Asia"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.1093\/eurheartj\/suab150","article-title":"Non-vitamin K antagonist oral anticoagulants in older and frail patients with atrial fibrillation","volume":"24","author":"R P Giugliano","year":"2022","journal-title":"Eur Heart J Suppl"},{"issue":"05","key":"ref28","first-page":"981","article-title":"Efficacy and safety of edoxaban in comparison with dabigatran, rivaroxaban and apixaban for stroke prevention in atrial fibrillation. An indirect comparison analysis","volume":"111","author":"F Skj\u00f8th","year":"2014","journal-title":"Thromb Haemost"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.ijcard.2021.11.008","article-title":"Comparison of clinical outcomes of edoxaban versus apixaban, dabigatran, rivaroxaban, and vitamin K antagonists in patients with atrial fibrillation in Germany: A real-world cohort study","volume":"346","author":"X L Marston","year":"2022","journal-title":"Int J Cardiol"},{"issue":"03","key":"ref30","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.chest.2019.04.108","article-title":"Effectiveness and safety of four direct oral anticoagulants in Asian patients with nonvalvular atrial fibrillation","volume":"156","author":"Y H Chan","year":"2019","journal-title":"Chest"},{"issue":"08","key":"ref31","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.1161\/STROKEAHA.119.025536","article-title":"Effectiveness and safety of contemporary oral anticoagulants among Asians with nonvalvular atrial fibrillation","volume":"50","author":"S R Lee","year":"2019","journal-title":"Stroke"},{"issue":"12","key":"ref32","doi-asserted-by":"crossref","first-page":"afac292","DOI":"10.1093\/ageing\/afac292","article-title":"Optimal stroke preventive strategy for patients aged 80 years or older with atrial fibrillation: A systematic review with traditional and network meta-analysis","volume":"51","author":"K H Lee","year":"2022","journal-title":"Age Ageing"},{"issue":"05","key":"ref33","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1161\/STROKEAHA.123.045098","article-title":"Effectiveness and safety of edoxaban compared with apixaban in elderly patients with nonvalvular atrial fibrillation: A real-world population-based cohort study","volume":"55","author":"R Chiv","year":"2024","journal-title":"Stroke"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"994085","DOI":"10.3389\/fcvm.2022.994085","article-title":"Adherence and persistence to oral anticoagulants in patients with atrial fibrillation: A Belgian nationwide cohort study","volume":"9","author":"M Grymonprez","year":"2022","journal-title":"Front Cardiovasc Med"},{"issue":"02","key":"ref35","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s40119-023-00315-8","article-title":"Anticoagulant treatment adherence and persistence in German patients with atrial fibrillation","volume":"12","author":"G Patti","year":"2023","journal-title":"Cardiol Ther"},{"issue":"04","key":"ref36","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1002\/bcp.70003","article-title":"Adherence and persistence with direct oral anticoagulants by dose regimen: A systematic review","volume":"91","author":"R Quir\u00f3s L\u00f3pez","year":"2025","journal-title":"Br J Clin Pharmacol"}],"container-title":["TH Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2822-9746.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T23:07:28Z","timestamp":1780528048000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2822-9746"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,23]]},"references-count":31,"journal-issue":{"issue":"CP","published-online":{"date-parts":[[2026,1,9]]},"published-print":{"date-parts":[[2026]]}},"alternative-id":["a28229746"],"URL":"https:\/\/doi.org\/10.1055\/a-2822-9746","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2512-9465"],"issn-type":[{"value":"2512-9465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,23]]}}}