Evidence map›Paper›PMID 38313978›Full record

ReviewCureus2024

Efficacy and Safety of Different Dosing Regimens of Rivaroxaban in Patients With Atrial Fibrillation for Stroke Prevention: A Systematic Review and Meta-Analysis.

Apurva Popat, Sagar K Patel, Susmitha Adusumilli, Ahmed Irshad, Aishwarya Nagaraj, Krisha K Patel, Stavan Y Jani, Gul Nawaz, Abdul Wahab, Satya Bora and 2 more

Open access · diamondAbstract readReview
In one paragraph

Review in Cureus, 2024. 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
0.8field-weighted citation impact, top 28% 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, 2 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
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 5 institutions in 3 countries.

Apurva PopatInternal Medicine, Marshfield Clinic Health System, Marshfield, USA.
Sagar K PatelInternal Medicine, Gujarat Adani Institute of Medical Sciences, Bhuj, IND.
Susmitha AdusumilliCollege of Medicine, Chongqing Medical University, Chongqing, CHN.
Ahmed IrshadInternal Medicine, Faisalabad Medical University, Faisalabad, PAK.
Aishwarya NagarajSurgery and Pharmacology, Our Lady of Fatima University, Bangalore, IND.
Krisha K PatelCollege of Medicine, Dr. M. K. Shah Medical College and Research Center, Ahmedabad, IND.
Stavan Y JaniInternal Medicine, Bukovinian State Medical University, Chernivtsi, UKR.
Gul NawazInternal Medicine, Allama Iqbal Medical College, Lahore, PAK.
Abdul WahabInternal Medicine, Sargodha Medical College, Sargodha, PAK.
Satya BoraNeurology, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada, IND.
Lakshay MittalInternal Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND.
Sweta YadavInternal Medicine, Gujarat Medical Education and Research Society (GMERS) Medical College, Ahmedabad, IND.
Adani Institute of Infrastructure Engineering · INAllama Iqbal Medical College · PKMarshfield Clinic · USPandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences · INPunjab Medical College · PK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Atrial fibrillation (AF) poses a substantial risk of stroke, necessitating effective anticoagulation therapy. This systematic review and meta-analysis (SRMA) evaluates the efficacy and safety of different dosing regimens of rivaroxaban in patients with AF. A comprehensive search of relevant databases, focusing on studies published from 2017 onward, was conducted. Inclusion criteria comprised randomized controlled trials (RCTs) and observational studies comparing standard and reduced dosing of rivaroxaban in AF. Data extraction and risk of bias (ROB) assessment were performed, and a meta-analysis was conducted for relevant outcomes. A total of 21 studies fulfilled the inclusion criteria. Standard dosing demonstrates a slightly lower risk of composite effectiveness outcomes and safety outcomes (HR: 0.79, 95% CI: 0.66-0.94, P=0.01) compared to reduced dosing (HR: 0.83, 95% CI: 0.71-0.97, P=0.02). Notable differences in major bleeding, gastrointestinal bleeding (GIB), and intracranial bleeding favored standard dosing. Hemorrhagic stroke and all-cause stroke rates differed significantly, with standard dosing showing a more favorable profile for ischemic stroke prevention. This study highlights the pivotal role of personalized anticoagulation therapy in AF. Standard dosing of rivaroxaban emerges as a preferred strategy for stroke prevention, balancing efficacy and safety. Clinical decision-making should consider individual patient characteristics and future research should delve into specific subpopulations and long-term outcomes to further refine treatment guidelines. The study bridges evidence from clinical trials to real-world practice, offering insights into the evolving landscape of AF management.

Indexed as

anticoagulation therapyatrial fibrillationclinical decision-makingefficacy and safetyhemorrhagic strokepersonalized medicinereal-world evidencerivaroxaban dosingstroke preventionsystematic review and meta-analysis

Identifiers

PMID38313978
PMCPMC10834223
OpenAlexW4390521152

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.