Summary

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• This summary is based on the review of 51 systematic review(s)/meta-analysis(es). ^[1-51]
• In elderly patients (≥75 years), direct oral anticoagulants (DOACs), particularly apixaban and edoxaban, demonstrate fewer thromboembolic events and lower bleeding risks compared to vitamin K antagonists (VKAs), supporting their use in this population.
• In patients with end-stage kidney disease on dialysis, factor Xa inhibitors (apixaban, rivaroxaban) effectively reduce the risk of stroke or systemic embolism (SSE) without increasing major bleeding, indicating their safety and efficacy in this high-risk group.
• In obese patients with atrial fibrillation (AF), DOACs show superior safety and efficacy profiles compared to VKAs, making them the preferred anticoagulant option in this population.
• In cancer patients, both apixaban and edoxaban are effective for venous thromboembolism (VTE) prevention, with apixaban potentially offering antithrombotic benefits without an increased risk of bleeding.
• Edoxaban is associated with a lower risk of major bleeding compared to warfarin, with a hazard ratio (HR) of 0.58 (95% confidence interval (CI): 0.49-0.69), indicating a significant safety advantage in this outcome.
• In patients with cancer, apixaban demonstrated a lower risk of major bleeding compared to edoxaban, with a hazard ratio of 0.38 (95% CI: 0.15-0.93), suggesting a preferable safety profile for apixaban in this population.
• There is no significant difference in the risk of gastrointestinal bleeding (GIB) between edoxaban and warfarin, with an odds ratio of 0.95 (95% CI: 0.79-1.13), indicating similar safety in this aspect.
• Edoxaban also shows a reduced risk of intracranial hemorrhage compared to warfarin, with a relative risk (RR) of 0.38 (95% CI: 0.29-0.48), reinforcing its safety in preventing severe bleeding events.