Asundexian Shows Lower Stroke Risk in oral anticoagulant Naive Patients: JAMA
Researchers have found in a new study that oral anticoagulants OAC-naive patients experienced a smaller increase in stroke or systemic embolism with asundexian compared to apixaban. However, this effect was less pronounced in OAC-experienced patients. The underlying mechanism remains unclear and requires further research. The study published in JAMA Cardiology was conducted by John H.A. and fellow researchers.
The trial, a prespecified exploratory analysis of the OCEANIC-AF trial, examined whether the asundexian effect differed between OAC-naive and OAC-experienced patients. The trial enrolled 14,810 participants at 1035 sites in 38 countries, and data were analyzed in June-July 2024. Stroke or systemic embolism was the primary efficacy outcome, and the main safety outcome was major bleeding.
This analysis divided AF patients into two groups according to previous OAC exposure: OAC naive (≤6 weeks of previous OAC use) and OAC experienced (>6 weeks of previous OAC use). Patients were assigned randomly to asundexian, a new factor XIa inhibitor, or apixaban, an established anticoagulant. The study evaluated the rates of stroke or systemic embolism and major bleeding in the two groups to compare differences in anticoagulant efficacy and safety.
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