ArticleCureus2025
Stroke and Thrombotic Events Associated With Concomitant Use of Oral Anticoagulants and Antiepileptic Drugs in the United States and Japan.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDirect oral anticoagulants (DOACs) are substrates of efflux P-glycoprotein (P-gp) transporters, and the hepatic enzyme cytochrome P450 plays an important role. Antiepileptic drugs (AEDs) may reduce absorption or increase the metabolism of DOACs, thereby reducing their antithrombotic efficacy. However, there is no evidence that concurrent use of metabolic inducers in patients taking DOACs is associated with an increased risk of stroke or thrombotic events.
methodsWe analyzed adverse event cases submitted to the Food and Drug Administration Adverse Event Reporting System (FAERS) from January 2010 to June 2023 and the Japanese Adverse Drug Event Report (JADER) database to April 2023. We compared the proportion of cases reporting thromboembolic and ischemic adverse events with the concomitant use of DOACs and first-generation drugs, such as phenytoin, metabolically inducing AEDs, to the proportion of cases with DOACs and control AEDs, such as levetiracetam.
resultsCompared with control AEDs, first-generation AEDs were associated with increased odds of reporting outcomes (reporting odds ratio {ROR}: 1.79, 95% confidence interval {CI}: 1.52-2.10, p<0.0001). Dabigatran, rivaroxaban, and apixaban were also similarly associated with increased reporting of outcome (ROR: 1.74, 95% CI: 1.26-2.39, ROR: 1.58, 95% CI: 1.24-2.02, and ROR: 2.07, 95% CI: 1.48-2.90). Edoxaban and JADER scores were not associated with patient outcomes.
conclusionWe observed an increase in the odds of reporting anticoagulation treatment failure among patients treated with DOACs and concomitant first-generation AEDs compared to those treated with control AEDs in the FAERS database. Care should be taken when administering dabigatran, apixaban, and rivaroxaban.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.