Non @entity2067 Oral Anticoagulants versus @entity1229 for @entity1 with XXXX : Absolute Benefit and Harm Assessments yield Novel Insights.

@entity1 @entity64 @entity548 @entity2067 @entity3926 @entity3925 @entity5424 @entity14242 @entity955 @entity1188 @entity204 @entity1229
BACKGROUND _ OBJECTIVES: Benefits and/or harms (including costs) of non- @entity2067 oral anticoagulants (NOACs) versus @entity1229 therapy need appreciation in relative and absolute terms. METHODS: Accordingly, we derived clinically relevant relative and absolute benefit/harm parameters for NOACs ( @entity5424 , @entity3926 , @entity3925 , @entity14242 ) compared to @entity1229 from four clinical trials involving @entity955 ( @entity955 ) @entity1 . For each trial, we tabulated @entity1 numbers enduring four important outcomes and calculated unadjusted relative risk reduction (RRR) and number needed to treat (NNT)/year values (and 95% confidence intervals) for the NAOC compared to @entity1229 . These outcomes were @entity64 (primary-endpoint), @entity548 , major @entity548 , and @entity204 . We also addressed drug acquisition costs. RESULTS: Each NOAC was non-inferior to @entity1229 for primary-outcome prevention; RRRs were 12-33% and NNT/year values were 182-481, and all but one indicated statistically significant superiority. All the NOACs yielded statistically significant reductions in @entity548 risk; RRRs were 42-74% and NNT/year values were 364-528. Major @entity548 risk was comparable in both groups. @entity5424 yielded a lower NNT/year for preventing @entity204 than for primary-outcome prevention. Compared to @entity1229 , NOAC acquisition costs were 70-140 fold greater. CONCLUSIONS: For the primary-outcome, the absolute benefits of NOACs were modest (NNT/year values being large). Reduced @entity548 rates with NOACs could be due to superior @entity1188 prevention and fewer consequential haemorrhagic transformations. Among @entity5424 recipients, the absolute mortality benefit exceeded that for the primary-outcome, indicating prevention of additional unrelated deaths. The substantially greater NOAC acquisition costs need viewing against probable greater safety and the avoidance of monitoring @entity548 risks. This article is protected by copyright. All rights reserved.
