Evidence map›Paper›PMID 38141156›Full record

ArticleDrug safety2024

Risk of Major Bleeding Associated with Concomitant Direct-Acting Oral Anticoagulant and Clopidogrel Use: A Retrospective Cohort Study.

Y Joseph Hwang, Hsien-Yen Chang, Thomas Metkus, Kathleen M Andersen, Sonal Singh, G Caleb Alexander, Hemalkumar B Mehta

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drug safety, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 26% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. 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

7 authors at 2 institutions in 1 country.

Y Joseph Hwang *Center for Drug Safety and Effectiveness, Johns Hopkins University, Baltimore, MD, USA. yhwang19@jhmi.edu.ORCID 0000-0002-0034-2292
Hsien-Yen Chang *Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Thomas MetkusDivisions of Cardiology and Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kathleen M AndersenCenter for Drug Safety and Effectiveness, Johns Hopkins University, Baltimore, MD, USA.
Sonal SinghUMass Chan Medical School, Worcester, MA, USA.
G Caleb AlexanderCenter for Drug Safety and Effectiveness, Johns Hopkins University, Baltimore, MD, USA.
Hemalkumar B MehtaCenter for Drug Safety and Effectiveness, Johns Hopkins University, Baltimore, MD, USA.
Johns Hopkins University · USUniversity of Massachusetts Chan Medical School · US

Funding

NHLBI Training Program in PharmacoepidemiologyT32HL139426 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI G. Caleb Alexander, JODI B. SEGAL · 2018 to 2026
$2.5M
Drug-Drug Interactions Involving Direct-Acting Oral Anticoagulants in Nursing Home ResidentsK01AG070329 · NIA · JOHNS HOPKINS UNIVERSITY · PI MEHTA, HEMALKUMAR B. · 2021 to 2025
$647k
NHLBI NIH HHS T32 HL139426NIA NIH HHS 5K01AG070329-02NIA NIH HHS K01 AG070329
6 · The paper itself

Abstract

BACKGROUND AND

aimCombined anticoagulant-antiplatelet therapy is often indicated in adults with cardiovascular disease and atrial fibrillation or venous thromboembolism. The study aim was to assess the comparative risk of bleeding between rivaroxaban and apixaban when combined with clopidogrel.

methodsWe conducted a retrospective cohort study of commercially insured US adults newly treated with a combination of rivaroxaban+clopidogrel or apixaban+clopidogrel (2015-2018) using Merative™ Marketscan Research Databases. We used propensity score-based inverse probability of treatment weighting (IPTW) to balance the treatment groups. Weighted Cox proportional hazards regression was used to estimate the risk of major bleeding.

resultsThe study cohort included 2895 rivaroxaban+clopidogrel users and 3628 apixaban+clopidogrel users. The median (range) duration of follow up was 61 (73) days. Rivaroxaban+clopidogrel users had a similar risk of major bleeding compared with apixaban+clopidogrel users (IPTW incidence rate per 100 person-years 7.96 vs 7.38; IPTW hazard ratio [HR] 1.13 [95% CI 0.78-1.63]). In the subcohort of adults who were treated with DOAC or clopidogrel monotherapy prior to the combined therapy, the risk of major bleeding did not differ by the drug of monotherapy (IPTW HR for rivaroxaban+clopidogrel group: 0.66 [95% CI 0.33-1.32]; IPTW HR for apixaban+clopidogrel group: 1.10 [95% CI 0.55-2.23])

conclusionsIn our study of commercially insured US adults, the concomitant use of rivaroxaban+clopidogrel and apixaban+clopidogrel conferred a similar risk of major bleeding. DOAC versus clopidogrel monotherapy prior to the concomitant therapy did not influence the risk of major bleeding.

Indexed as

Atrial FibrillationStrokeAdministration, OralAdultAnticoagulantsClopidogrelDabigatranFactor Xa InhibitorsHemorrhageHumansPyridonesRetrospective StudiesRivaroxabanAnticoagulantsClopidogrelDabigatranFactor Xa InhibitorsPyridonesRivaroxaban

Identifiers

PMID38141156
PMCPMC10942724
OpenAlexW4390143603

What OpenQuestion holds

Textmetadata
LicenceTDM
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.