Clinical Edge

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DOACs linked to lower fracture risk versus warfarin in AFib patients

Key clinical point: Among patients with atrial fibrillation, use of direct oral anticoagulants is linked to lower osteoporotic fracture risk versus warfarin.

Major finding: Direct oral anticoagulant use was consistently associated with a lower risk of osteoporotic fractures versus warfarin, regardless of the direct oral anticoagulant considered. Hazard ratios were 0.62 (95% confidence interval, 0.41-0.94) for apixaban, 0.65 (95% CI, 0.49-0.86) for dabigatran, and 0.52 (95% CI, 0.37-0.73) for rivaroxaban versus warfarin.

Study details: A population-based cohort study including electronic health records in a Hong Kong database for 23,515 older adults with a new diagnosis of atrial fibrillation who received a new prescription of warfarin or a direct oral anticoagulant.

Disclosures: Funding for the study came from the University of Hong Kong and University College London Strategic Planning Fund. The study authors reported disclosures related to Bayer, Bristol-Myers Squibb, Pfizer, Janssen, Amgen, Takeda, IQVIA, and others.


Lau WCY et al. Ann Intern Med. 2020 May 18. doi: 10.7326/M19-3671.