What are the effects of NOACs vs warfarin in Asians vs non-Asians?
A recent meta-analysis comprising 5 NOAC trials found that the effects of NOACs vs warfarin in 1154 Asians vs non-Asians were compared. For standard-dose NOACs (dabigatran 150 mg, rivaroxaban 20 mg, apixaban 5 mg, and edoxaban 60 mg), the effect sizes of the primary efficacy end point (stroke and systemic embolism) and the primary safety end point (major bleeding) were greater in Asians vs non-Asians. The risk reduction in hemorrhagic stroke and gastrointestinal bleeding was also greater in Asians vs non-Asians. These data suggest that standard-dose NOACs, when compared with warfarin, were more effective and safer in Asians than in non-Asians. The efficacy and safety of low-dose NOACs (dabigatran 110 mg, rivaroxaban 15 mg, and edoxaban 30 mg), when compared with warfarin, appear similar among Asians and non-Asians.