Edoxaban Anticoagulation in Atrial Fibrillation: Real World Data and Evidence

Atrial fibrillation (AF) and stroke are two prevalent health conditions with many common risk factors. In the last two decades, non-vitamin K antagonist oral anticoagulants (NOACs) have become an important alternative to vitamin K antagonists due to their efficacy and safety profile and not requiring frequent international normalized ratio monitoring. Edoxaban is the most recently developed currently available NOAC and has been approved for stroke prevention in non-valvular AF in many countries around the world since 2014. The pivotal, phase III ENGAGE AF-TIMI 48 trial demonstrated that edoxaban is as efficacious as warfarin in preventing strokes and systemic embolic events and is associated with lower rates of major, life-threatening, intracranial, major or clinically relevant non-major bleedings, and reduced cardiovascular mortality in AF compared to warfarin. Data are accumulating on the use of edoxaban in patients with AF in clinical practice. This article provides an overview of real-world data/evidence on edoxaban use for the prevention of stroke/ systemic embolic events in patients with AF, focusing on the issues that physicians consider in the clinical decision-making process.