Risk of gastrointestinal bleeding with dabigatran: A head-to-head comparative study with rivaroxaban

Muhammed Sherid, Humberto Sifuentes, Samian Sulaiman, Salih Samo, Husein Husein, Ruth Tupper, Dharma S Thiruvaiyaru, Charles Spurr, Subbaramiah Sridhar

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Introduction: The risk of gastrointestinal (GI) bleeding of dabigatran and rivaroxaban is relatively unexplored. The aim of our study was to compare this risk in both drugs. Methods: We examined the medical records of patients on either dabigatran or rivaroxaban from October 2010 to April 2013 in two hospitals. Results: A total of 374 patients (147 rivaroxaban vs. 227 dabigatran) were identified. GI bleeding occurred in 5.3% in the dabigatran when compared to 4.8% in the rivaroxaban group (p = 0.8215). Multivariate analysis showed that the odds of GI bleeding while on dabigatran for ≤ 40 days when compared to ≥ 40 days was 8.3 (p < 0.0001). In the rivaroxaban group, patients who were on the drug for ≤ 40 days had a higher incidence of bleeding when compared to those >40 days (OR = 2.8, p = 0.023). Concomitant use of antiplatelets (single or dual) or non-steroidal anti-inflammatory drugs was not associated with increased bleeding in the dabigatran group; however, the use of dual antiplatelet agents with rivaroxaban was associated with an increased risk of GI bleeding (OR = 7.4, p = 0.0378). Prior GI bleeding had a higher risk of bleeding in the rivaroxaban group (OR = 15.5, p = 0.0002). Conclusion: Dabigatran was not associated with a higher incidence of GI bleeding. Both drugs had a higher bleeding risk in the first 40 days.

Original languageEnglish (US)
Pages (from-to)137-146
Number of pages10
JournalDigestion
Volume90
Issue number2
DOIs
StatePublished - Jan 1 2014

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Hemorrhage
Pharmaceutical Preparations
Dabigatran
Rivaroxaban
Platelet Aggregation Inhibitors
Medical Records
Anti-Inflammatory Agents
Multivariate Analysis
Incidence

Keywords

  • Age
  • Antiplatelet agents
  • Gastrointestinal bleeding
  • Rivaroxaban
  • Warfarin

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

Cite this

Risk of gastrointestinal bleeding with dabigatran : A head-to-head comparative study with rivaroxaban. / Sherid, Muhammed; Sifuentes, Humberto; Sulaiman, Samian; Samo, Salih; Husein, Husein; Tupper, Ruth; Thiruvaiyaru, Dharma S; Spurr, Charles; Sridhar, Subbaramiah.

In: Digestion, Vol. 90, No. 2, 01.01.2014, p. 137-146.

Research output: Contribution to journalArticle

Sherid, Muhammed ; Sifuentes, Humberto ; Sulaiman, Samian ; Samo, Salih ; Husein, Husein ; Tupper, Ruth ; Thiruvaiyaru, Dharma S ; Spurr, Charles ; Sridhar, Subbaramiah. / Risk of gastrointestinal bleeding with dabigatran : A head-to-head comparative study with rivaroxaban. In: Digestion. 2014 ; Vol. 90, No. 2. pp. 137-146.
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AU - Sifuentes, Humberto

AU - Sulaiman, Samian

AU - Samo, Salih

AU - Husein, Husein

AU - Tupper, Ruth

AU - Thiruvaiyaru, Dharma S

AU - Spurr, Charles

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N2 - Introduction: The risk of gastrointestinal (GI) bleeding of dabigatran and rivaroxaban is relatively unexplored. The aim of our study was to compare this risk in both drugs. Methods: We examined the medical records of patients on either dabigatran or rivaroxaban from October 2010 to April 2013 in two hospitals. Results: A total of 374 patients (147 rivaroxaban vs. 227 dabigatran) were identified. GI bleeding occurred in 5.3% in the dabigatran when compared to 4.8% in the rivaroxaban group (p = 0.8215). Multivariate analysis showed that the odds of GI bleeding while on dabigatran for ≤ 40 days when compared to ≥ 40 days was 8.3 (p < 0.0001). In the rivaroxaban group, patients who were on the drug for ≤ 40 days had a higher incidence of bleeding when compared to those >40 days (OR = 2.8, p = 0.023). Concomitant use of antiplatelets (single or dual) or non-steroidal anti-inflammatory drugs was not associated with increased bleeding in the dabigatran group; however, the use of dual antiplatelet agents with rivaroxaban was associated with an increased risk of GI bleeding (OR = 7.4, p = 0.0378). Prior GI bleeding had a higher risk of bleeding in the rivaroxaban group (OR = 15.5, p = 0.0002). Conclusion: Dabigatran was not associated with a higher incidence of GI bleeding. Both drugs had a higher bleeding risk in the first 40 days.

AB - Introduction: The risk of gastrointestinal (GI) bleeding of dabigatran and rivaroxaban is relatively unexplored. The aim of our study was to compare this risk in both drugs. Methods: We examined the medical records of patients on either dabigatran or rivaroxaban from October 2010 to April 2013 in two hospitals. Results: A total of 374 patients (147 rivaroxaban vs. 227 dabigatran) were identified. GI bleeding occurred in 5.3% in the dabigatran when compared to 4.8% in the rivaroxaban group (p = 0.8215). Multivariate analysis showed that the odds of GI bleeding while on dabigatran for ≤ 40 days when compared to ≥ 40 days was 8.3 (p < 0.0001). In the rivaroxaban group, patients who were on the drug for ≤ 40 days had a higher incidence of bleeding when compared to those >40 days (OR = 2.8, p = 0.023). Concomitant use of antiplatelets (single or dual) or non-steroidal anti-inflammatory drugs was not associated with increased bleeding in the dabigatran group; however, the use of dual antiplatelet agents with rivaroxaban was associated with an increased risk of GI bleeding (OR = 7.4, p = 0.0378). Prior GI bleeding had a higher risk of bleeding in the rivaroxaban group (OR = 15.5, p = 0.0002). Conclusion: Dabigatran was not associated with a higher incidence of GI bleeding. Both drugs had a higher bleeding risk in the first 40 days.

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KW - Warfarin

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