SynthesisDrugs & aging2026
Efficacy and Safety of DOACs in Patients with Atrial Fibrillation and History of Falls or Risk of Falls: The Liverpool AF-Falls Project. A Systematic Review and Bayesian Network Meta-analysis.
Synthesis in Drugs & aging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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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
1 citing paper in PubMed.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeNon-vitamin K antagonist oral anticoagulants (DOACs) are the preferred treatment over vitamin K antagonists (VKAs) for patients with atrial fibrillation (AF). However, AF patients at risk or with history of falls seldom receive anticoagulants due to the bleeding risk. The objective was to assess the efficacy and safety of DOACs in AF patients with history or risk of falls.
methodsA systematic literature review was conducted until October 31, 2024. Primary outcomes were stroke/systemic embolism (SSE) and major bleeding (MB). Bayesian network meta-analyses were conducted. Hazard ratios (HRs) with 95% credible intervals (CrI) quantified the effect of drugs; cumulative ranking curves (SUCRA) were used to determine their hierarchy.
resultsOut of 961 articles, 10 articles (5 randomized controlled trials and 5 observational studies) were retained for quantitative synthesis. Risk of bias was moderate to serious. In reducing the risk of SSE compared with VKAs, apixaban had a SUCRA of 0.87 (HR 0.72, 95% CrI 0.59-0.96), followed by rivaroxaban (HR 0.80; 95% CrI 0.63-0.99; SUCRA 0.68), edoxaban (HR 0.96; 95% CrI 0.48-1.91; SUCRA 0.38) and dabigatran (HR 0.92; 95% CrI 0.68-1.28; SUCRA 0.37). In reducing the risk of MB, compared with VKAs, edoxaban had a SUCRA of 0.86 (HR 0.66; 95% CrI 0.50-0.92) followed by apixaban (HR 0.67; 95% CrI 0.55-0.87; SUCRA 0.83), and dabigatran (HR 0.79; 95% CrI 0.64-1.00; SUCRA 0.54).
conclusionsDOACs appear to have different efficacy and safety profiles and overall are preferable over VKAs in patients with AF with a history or risk of falls. Because of bias, further research is warranted.
trial registrationPROSPERO identifier no. CRD42020201086.
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