ArticleFederal practitioner : for the health care professionals of the VA, DoD, and PHS2024
Impact of NSAID Use on Bleeding Rates for Patients Taking Rivaroxaban or Apixaban.
Article in Federal practitioner : for the health care professionals of the VA, DoD, and PHS, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed.
- Opioid-Free Pain Management Strategies for Patients on Oral Anticoagulation Undergoing Soft Tissue Hand Surgery.The Journal of hand surgery · 2025Review
- Direct Oral anticoagulants in pulmonary thromboembolism therapy: the generalization-individualization dilemma and the path to risk stratification-a perspective.Frontiers in medicine · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Posthoc analyses have found an increased bleeding risk in oral anticoagulation with concomitant nonsteroidal anti-inflammatory drug (NSAID) use. However, this research was primarily conducted in mixed populations prescribed both direct oral anticoagulants (DOACs) and warfarin. Research evaluating bleeding risk with NSAID use among DOACs alone is limited. This study evaluates bleeding rates in patients taking rivaroxaban and apixaban with and without NSAID use and investigates the potential impact of NSAID selectivity or proton pump inhibitor (PPI) coprescribing. Methods: This single-center retrospective cohort study compared bleeding rates between rivaroxaban or apixaban among NSAID and non-NSAID users. The primary endpoint was a composite of any bleeding event per International Society on Thrombosis and Haemostatis criteria. The secondary endpoint was bleeding rates for NSAID users based on NSAID choice and PPI coprescribing. Results: The study included 681 patients on rivaroxaban and 3225 patients on apixaban. Seventy-two patients on rivaroxaban (10.6%) and 300 patients on apixaban (9.3%) were NSAID users. There was no statistically significant difference between rivaroxaban and apixaban among NSAID users (hazard ratio 1.04; 95% CI, 0.98-1.12) or non-NSAID users (hazard ratio 1.15; 95% CI, 0.80-1.66). There was no clinically significant difference observed for NSAID selectivity or PPI coprescribing for NSAID users. Conclusions: Bleeding rates were not significantly different between patients taking rivaroxaban and patients taking apixaban, regardless of NSAID use. A population health management tool may provide a safe approach for coprescribing NSAIDs with DOACs. Additional prospective studies are needed to quantify the comparative bleeding risk with concomitant NSAID use among DOACs alone.
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Registered trials
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