Evidence map›Paper›PMID 42132160›Full record

Trial reportJournal of the American Heart Association2026

Association of Edoxaban Pharmacokinetics With Bleeding in Older Patients With Atrial Fibrillation Treated With Low-Dose Edoxaban: A Post Hoc Analysis of a Randomized Controlled Trial.

Ken Okumura, Masaharu Akao, Masayuki Fukuzawa, Yoshiyuki Igawa, Takuya Hayashi, Takeshi Yamashita

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02801669 (A Phase 3, Randomized, Double-blind, Placebo-controlled, Parallel-group, Multicenter Study of DU-176b in Patients With NVAF Aged 80 Years or Older Who Are Ineligible for Available Oral Anticoagulation Therapy), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

NCT02801669 phase3completednot on this map

A Phase 3, Randomized, Double-blind, Placebo-controlled, Parallel-group, Multicenter Study of DU-176b in Patients With NVAF Aged 80 Years or Older Who Are Ineligible for Available Oral Anticoagulation Therapy

TypeinterventionalSponsorDaiichi Sankyo Co., Ltd.Ran2016 to 2019Enrolled984ConditionsAtrial FibrillationArmsDu-176b, placebo
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

6 authors.

Ken OkumuraDivision of Cardiology Saiseikai Kumamoto Hospital Kumamoto Japan.ORCID 0000-0002-3202-7203
Masaharu AkaoDepartment of Cardiology National Hospital Organization Kyoto Medical Center Kyoto Japan.ORCID 0000-0002-2348-7646
Masayuki FukuzawaJapan Business Unit, Primary Medical Science Department, Cardiovascular Group Daiichi Sankyo Co., Ltd. Tokyo Japan.ORCID 0000-0001-8723-7489
Yoshiyuki IgawaQuantitative Clinical Pharmacology Department Daiichi Sankyo Co., Ltd. Tokyo Japan.
Takuya HayashiData Analysis Group, Data Intelligence Department Global DX, Daiichi Sankyo Co., Ltd. Tokyo Japan.
Takeshi YamashitaThe Cardiovascular Institute Tokyo Japan.ORCID 0000-0002-2544-8464

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEdoxaban is a direct oral anticoagulant used for stroke prevention in patients with atrial fibrillation (AF) and treatment of venous thromboembolism. We examined the relationship between trough edoxaban concentrations (E-trough) and prothrombin time (PT) and major bleeding in very old Japanese patients with atrial fibrillation and high bleeding risk.

methodsIn this post hoc analysis of the multicenter, randomized, double-blind, placebo-controlled ELDERCARE-AF (Study of DU-176b Aged 80 Years or Older) trial, patients were randomly assigned 1:1 to edoxaban 15 mg or placebo once daily. After 8 weeks of treatment, E-trough was determined and the incidence of major bleeding examined in each quartile. The incidence of major bleeding by PT was also examined.

resultsData were obtained from 427 patients. E-trough (ng/mL) was ≤9.24 in the first quartile (107 patients), >9.24 to ≤13.6 in the second (111 patients), >13.6 to ≤21.6 in the third (103 patients), and >21.6 in the fourth (106 patients). Older age, lower body weight, lower creatinine clearance, and the presence of congestive heart failure were independent predictors of higher E-trough. Higher E-trough was associated with greater incidence of major bleeding (0.8%, 1.9%, 3.4%, and 4.7%/year, respectively,

conclusionsSeveral factors were associated with higher E-trough and increased risk of major bleeding events. PT >13 seconds may be a useful predictor of the development of major bleeding. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02801669.

Indexed as

Atrial FibrillationFactor Xa InhibitorsHemorrhagePyridinesStrokeThiazolesAdministration, OralAged, 80 and overAge FactorsDouble-Blind MethodFemaleHumansIncidenceJapanMaleProthrombin TimeedoxabanFactor Xa InhibitorsPyridinesThiazolesatrial fibrillationbleedingedoxabanpharmacokineticsprothrombin time

Identifiers

PMID42132160
PMCPMC13279454

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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.