Abstract:
OBJECTIVE:To do an indirect comparison analysis of apixaban against dabigatran etexilate (2 doses) and rivaroxaban (1 dose), as well as of rivaroxaban against dabigatranetexilate (2 doses), for their relative efficacy and safety against each other, with particular focus on the secondary prevention population for stroke prevention in atrial fibrillation. A secondary objective was to do the same analysis in the primary prevention cohort. DESIGN:Indirect treatment comparisons of phase III clinical trials of stroke prevention in atrial fibrillation, with a focus on the secondary prevention cohorts. A secondary analysis was done on the primary prevention cohort. DATA SOURCES:Medline and Central (up to June 2012), clinical trials registers, conference proceedings, and websites of regulatory agencies. STUDY SELECTION:Randomised controlled trials of rivaroxaban, dabigatran, or apixaban compared with warfarin for stroke prevention in atrial fibrillation. RESULTS:In the secondary prevention (previous stroke) subgroup, when apixaban was compared with dabigatran (110 mg and 150 mg twice daily) for efficacy and safety endpoints, the only significant difference seen was less myocardial infarction (hazard ratio 0.39, 95% confidence interval 0.16 to 0.95) with apixaban compared with dabigatran 150 mg twice daily. No significant differences were seen in efficacy and most safety endpoints between apixaban or dabigatran 150 mg twice daily versus rivaroxaban. Less haemorrhagic stroke (hazard ratio 0.15, 0.03 to 0.66), vascular death (0.64, 0.42 to 0.99), major bleeding (0.68, 0.47 to 0.99), and intracranial bleeding (0.27, 0.10 to 0.73) were seen with dabigatran 110 mg twice daily versus rivaroxaban. In the primary prevention (no previous stroke) subgroup, apixaban was superior to dabigatran 110 mg twice daily for disabling or fatal stroke (hazard ratio 0.59, 0.36 to 0.97). Compared with dabigatran 150 mg twice daily, apixaban was associated with more stroke (hazard ratio 1.45, 1.01 to 2.08) and with less major bleeding (0.75, 0.60 to 0.94), gastrointestinal bleeding (0.61, 0.42 to 0.89), and other location bleeding (0.74, 0.58 to 0.94). Compared with rivaroxaban, dabigatran 110 mg twice daily was associated with more myocardial infarction events. No significant differences were seen for the main efficacy and safety endpoints between dabigatran 150 mg twice daily and rivaroxaban, or in efficacy endpoints between apixaban and rivaroxaban. Apixaban was associated with less major bleeding (hazard ratio 0.61, 0.48 to 0.78) than rivaroxaban. CONCLUSIONS:For secondary prevention, apixaban, rivaroxaban, and dabigatran had broadly similar efficacy for the main endpoints, although the endpoints of haemorrhagic stroke, vascular death, major bleeding, and intracranial bleeding were less common with dabigatran 110 mg twice daily than with rivaroxaban. For primary prevention, the three drugs showed some differences in relation to efficacy and bleeding. These results are hypothesis generating and should be confirmed in a head to head randomised trial.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Rasmussen LH,Larsen TB,Graungaard T,Skjøth F,Lip GYdoi
10.1136/bmj.e7097subject
Has Abstractpub_date
2012-11-05 00:00:00pages
e7097eissn
0959-8138issn
1756-1833journal_volume
345pub_type
杂志文章abstract:OBJECTIVE:To investigate the association between tea drinking habits in Golestan province, northern Iran, and risk of oesophageal squamous cell carcinoma. DESIGN:Population based case-control study. In addition, patterns of tea drinking and temperature at which tea was drunk were measured among healthy participants in...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.b929
更新日期:2009-03-26 00:00:00
abstract:OBJECTIVE:To examine how the relaxation of the one child policy and policies to reduce caesarean section rates might have affected trends over time in caesarean section rates and perinatal and pregnancy related mortality in China. DESIGN:Observational study. SETTING:China's National Maternal Near Miss Surveillance Sy...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.k817
更新日期:2018-03-05 00:00:00
abstract::The author is one of the medical advisers to the judge who led a government inquiry into allegations that an experimental research program at the National Women's Hospital in Auckland, New Zealand, to study the natural course of cervical carcinoma in situ had withheld conventional treatment from some patients. She ar...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6647.533
更新日期:1988-08-20 00:00:00
abstract::Objective To improve the selection of patients with acute ischaemic stroke for intra-arterial treatment using a clinical decision tool to predict individual treatment benefit.Design Multivariable regression modelling with data from two randomised controlled clinical trials.Setting 16 hospitals in the Netherlands (deri...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.j1710
更新日期:2017-05-03 00:00:00
abstract:OBJECTIVE:To assess the risk of adverse perinatal events of vaccination of pregnant women with an MF59 adjuvanted vaccine. DESIGN:Cross sectional multicentre study. SETTING:49 public hospitals in major cities in Argentina, from September 2010 to May 2011. PARTICIPANTS:30,448 mothers (7293 vaccinated) and their 30,76...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.f393
更新日期:2013-02-04 00:00:00
abstract:OBJECTIVE:To study different nutrients and food additives as risk factors for insulin dependent diabetes mellitus in childhood. DESIGN:Prospective case-control study. Parents of the children being studied were asked to fill in a questionnaire regarding the children's frequency of consumption of various foods. Parents ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6735.1302
更新日期:1990-05-19 00:00:00
abstract::The rapid aging of populations in developing countries as compared to those in the developed world has implications for medical training in these places. Moreover, the growing globalization of employment for many health professionals means that demographic shifts have implications for the training of health professio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.319.7221.1358
更新日期:1999-11-20 00:00:00
abstract:OBJECTIVE:To evaluate risk of late life coronary heart disease associated with being overweight in late middle or old age and to assess whether weight change modifies this risk. DESIGN:Longitudinal study of subjects in the epidemiological follow up study of the national health and nutrition examination survey I. SETT...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7097.1791
更新日期:1997-06-21 00:00:00
abstract:OBJECTIVE:To determine whether a booklet given to patients being discharged from hospital giving details of their admission and treatment increased their knowledge and recall when reviewed in outpatient clinics. DESIGN:Patients alternately allocated to receive a booklet or to serve as controls. Assessment by a questio...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.298.6677.870
更新日期:1989-04-01 00:00:00
abstract:OBJECTIVE:To determine the long term effects of antibiotic treatment for acute otitis media in young children. DESIGN:Prospective three year follow-up study within the framework of a primary care based, double blind, randomised, placebo controlled trial. SETTING:53 general practices in the Netherlands. PARTICIPANTS:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.b2525
更新日期:2009-06-30 00:00:00
abstract:OBJECTIVE:To describe and quantify the patients and clinical activities of independent short stay hospitals. DESIGN:Retrospective survey of hospital records for sampled periods of one financial year and comparison with data from 1981 to 1986. SETTING:217 independent hospitals in England and Wales, 1992-3. MAIN OUTCO...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.308.6945.1699
更新日期:1994-06-25 00:00:00
abstract:OBJECTIVE:To examine whether the association of inadequate or unclear allocation concealment and lack of blinding with biased estimates of intervention effects varies with the nature of the intervention or outcome. DESIGN:Combined analysis of data from three meta-epidemiological studies based on collections of meta-an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.39465.451748.AD
更新日期:2008-03-15 00:00:00
abstract:OBJECTIVE:To accurately measure the incidence of gastric cancer among patients with gastric precancerous lesions, and to quantify the excess incidence in comparison with people with normal mucosa on endoscopy and a general population. DESIGN:Population based cohort study. SETTING:Population of Sweden using data from ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h3867
更新日期:2015-07-27 00:00:00
abstract:OBJECTIVE:To investigate the long term effects of continuous subcutaneous insulin infusion (insulin pump therapy) on cardiovascular diseases and mortality in people with type 1 diabetes. DESIGN:Observational study. SETTING:Swedish National Diabetes Register, Sweden 2005-12. PARTICIPANTS:18,168 people with type 1 dia...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h3234
更新日期:2015-06-22 00:00:00
abstract::A US organization, Population Action International, is reported in this article to have released findings on the health risks for women in 118 countries. Countries are ranked on 10 indicators, including such indicators as the number of births to women aged under 19 years, the availability of legal abortion, maternal ...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.311.6998.147a
更新日期:1995-07-15 00:00:00
abstract:OBJECTIVE:To compare ultrasonography with intravenous urography in the investigation of adults with haematuria. DESIGN:Prospective study entailing the examination of all patients with both investigations concurrently. The investigations were performed independently on routine lists by different duty radiologists. Each...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.301.6760.1074
更新日期:1990-11-10 00:00:00
abstract::Cancer control encompasses the whole spectrum from prevention and early diagnosis to treatment and palliation. The key to the future of cancer control will be to establish multidisciplinary approaches to each type of cancer across this spectrum. For primary prevention this requires some understanding of the causes of ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.309.6952.449
更新日期:1994-08-13 00:00:00
abstract:OBJECTIVE:To characterise the percentage of available outcome data being presented in reports of randomised clinical trials with continuous outcome measures, thereby determining the potential for incomplete reporting bias. DESIGN:Descriptive cross sectional study. DATA SOURCES:A random sample of 200 randomised trials...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e8486
更新日期:2012-12-18 00:00:00
abstract:OBJECTIVES:To review completed trials assessing effect of hormone replacement therapy on subsequent risk of stroke, assessing stroke by pathological type, severity, and outcome. DESIGN:Systematic review of randomised controlled trials identified from the Cochrane Library, Embase, and Medline; reviews; and reference li...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.38331.655347.8F
更新日期:2005-02-12 00:00:00
abstract:OBJECTIVE:To compare health behaviours during pregnancy (smoking and alcohol consumption) and after birth (initiation and duration of breast feeding) between British/Irish white mothers and mothers from ethnic minority groups; and, in mothers from ethnic minority groups, to examine whether indicators of acculturation (...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.39532.688877.25
更新日期:2008-05-10 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of oral rehydration in children with moderate dehydration caused by gastroenteritis, and to compare the complications of oral and intravenous treatment. DESIGN:Randomised controlled trial. SETTING:Emergency department and infectious diseases ward in a large urban teaching hosp...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.303.6799.393
更新日期:1991-08-17 00:00:00
abstract:OBJECTIVE:To determine whether cognitive therapy is effective in preventing the worsening of emerging psychotic symptoms experienced by help seeking young people deemed to be at risk for serious conditions such as schizophrenia. DESIGN:Multisite single blind randomised controlled trial. SETTING:Diverse services at fi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.e2233
更新日期:2012-04-05 00:00:00
abstract:OBJECTIVE:To assess the association between genitourinary infections in the month before conception to the end of the first trimesterand gastroschisis. DESIGN:Case-control study with self reported infections from a computer assisted telephone interview. SETTING:National birth defects prevention study, a multisite, po...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.39567.509074.25
更新日期:2008-06-21 00:00:00
abstract:OBJECTIVE:To evaluate the association between body mass index and mortality from overall cardiovascular disease and specific subtypes of cardiovascular disease in east and south Asians. DESIGN:Pooled analyses of 20 prospective cohorts in Asia, including data from 835,082 east Asians and 289,815 south Asians. Cohorts w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.f5446
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:To investigate the circumstances since the 1950s in which people who were attracted to members of the same sex received treatments to change their sexual orientation, the referral pathway and the process of therapy, and its aftermath. DESIGN:A nationwide study based on qualitative interviews. PARTICIPANTS:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.37984.442419.EE
更新日期:2004-02-21 00:00:00
abstract:OBJECTIVE:To investigate the impact of coexistent psychiatric morbidity on risk of suicide after a suicide attempt. DESIGN:Cohort study with follow-up for 21-31 years. SETTING:Swedish national register based study. PARTICIPANTS:39 685 people (53% women) admitted to hospital for attempted suicide during 1973-82. MAI...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.a2205
更新日期:2008-11-18 00:00:00
abstract:OBJECTIVE:To investigate a reported association between dental disease and risk of coronary heart disease. SETTING:National sample of American adults who participated in a health examination survey in the early 1970s. DESIGN:Prospective cohort study in which participants underwent a standard dental examination at bas...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6879.688
更新日期:1993-03-13 00:00:00
abstract:STUDY QUESTION:Does maternal smoking during pregnancy and exposure of infants to tobacco smoke at age 4 months increase the risk of caries in deciduous teeth? METHODS:Population based retrospective cohort study of 76 920 children born between 2004 and 2010 in Kobe City, Japan who received municipal health check-ups at...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h5397
更新日期:2015-10-21 00:00:00
abstract:OBJECTIVES:To evaluate the evidence for strategies to prevent falls or fractures in residents in care homes and hospital inpatients and to investigate the effect of dementia and cognitive impairment. DESIGN:Systematic review and meta-analyses of studies grouped by intervention and setting (hospital or care home). Meta...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.39049.706493.55
更新日期:2007-01-13 00:00:00
abstract::The benefits to medical practitioners of using the Internet are growing rapidly as the Internet becomes easier to use and ever more biomedical resources become available on line. The Internet is the largest computer network in the world; it is also a virtual community, larger than many nation states, with its own rule...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.311.7017.1422
更新日期:1995-11-25 00:00:00