Evidence map›Paper›PMID 34651200›Full record

SynthesisEuropean journal of clinical pharmacology2022

Standard- vs. low-dose rivaroxaban in patients with atrial fibrillation: a systematic review and meta-analysis.

Guangyan Mu, Hanxu Zhang, Zhiyan Liu, Qiufen Xie, Shuang Zhou, Zining Wang, Zhe Wang, Kun Hu, Jingyi Hou, Nan Zhao and 2 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of clinical pharmacology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Guangyan Mu *Department of Pharmacy, Peking University First Hospital, Beijing, China.
Hanxu Zhang *Department of Pharmacy, Peking University First Hospital, Beijing, China.
Zhiyan LiuDepartment of Pharmacy, Peking University First Hospital, Beijing, China.
Qiufen XieDepartment of Pharmacy, Peking University First Hospital, Beijing, China.
Shuang ZhouDepartment of Pharmacy, Peking University First Hospital, Beijing, China.
Zining WangDepartment of Pharmacy, Peking University First Hospital, Beijing, China.
Zhe WangDepartment of Pharmacy, Peking University First Hospital, Beijing, China.
Kun HuDepartment of Pharmacy, Peking University First Hospital, Beijing, China.
Jingyi HouDepartment of Pharmacy, Peking University First Hospital, Beijing, China.
Nan ZhaoDepartment of Pharmacy, Peking University First Hospital, Beijing, China.
Qian XiangDepartment of Pharmacy, Peking University First Hospital, Beijing, China. xiangqz@pkufh.com.
Yimin CuiDepartment of Pharmacy, Peking University First Hospital, Beijing, China. cui.pharm@pkufh.com.ORCID http://orcid.org/0000-0002-4186-1005
Peking University · CN

Funding

National Key R&D Program of China No. 2016YFC0904900National Natural Science Foundation of China No. 81872940National Natural Science Foundation of China No. 81973395National Natural Science Foundation of China No. 82073935National Science and Technology Major Projects for "Major New Drugs Innovation and Development" of China No.2017ZX09101001National Science and Technology Major Projects for "Major New Drugs Innovation and Development" of China No.2017ZX09304028National Science and Technology Major Projects for "Major New Drugs Innovation and Development" of China No. 2018ZX09201014Natural Science Foundation of Beijing Municipality No. 7171012
6 · The paper itself

Abstract

purposeLow-dose rivaroxaban is often given to patients with atrial fibrillation (AF) around the world, but the rationale for its use remains unclear. We aimed to compare the efficacy and safety of standard- or low-dose rivaroxaban in patients with AF through systematic review of literature with meta-analysis.

methodsWe searched PubMed, Web of Science, EMBASE, Clinical Trials.gov, the Cochrane Library, and Bayer trial website from inception of each database until June 2020. Randomized controlled trials (RCTs) and cohort studies were included in the meta-analysis. A random-effects model was employed to calculate the pooled effect estimates.

resultsTwo RCTs and 17 cohort studies were included in the qualitative analysis. Indirect comparison of RCTs showed no significant difference between the two rivaroxaban dosages in risk of efficacy or safety outcomes (p > 0.05). Indirect comparison of cohort studies showed a lower risk of MACE among Caucasians in standard-dose group (HR 0.779; 95% CI 0.687-0.884; p < 0.001). Bleeding outcomes did not differ significantly between the two dosage regimens in Asian or Caucasian populations, except that the standard dose was associated with higher risk of major bleeding among elderly Caucasian patients (HR 1.329; 95% CI 1.141-1.547; p < 0.001). The quality of evidence was rated ranging from very low to low for all the efficacy and safety outcomes.

conclusionIn Caucasians with AF, standard-dose rivaroxaban may prevent MACE significantly better than low-dose treatment. Further studies in Asians are needed to verify the advantages of the standard dose.

Indexed as

AnticoagulantsAsian PeopleAtrial FibrillationCohort StudiesDose-Response Relationship, DrugHemorrhageHumansRandomized Controlled Trials as TopicRivaroxabanStrokeWhite PeopleAnticoagulantsRivaroxabanAtrial fibrillationDosageMeta-analysisRivaroxaban

Identifiers

PMID34651200
OpenAlexW3207885497

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.