Edoxaban (Lixiana)
Common Drug Review
Atrial fibrillation (AF) is a common cardiac arrhythmia,1,2 characterized by disorganized, rapid, and irregular activity of the atria (i.e., the upper chambers of the heart).3 AF is recognized as a chronic, progressive disorder associated with increased morbidity and mortality.4–6 The Heart and Stroke Foundation estimates that approximately 350,000 Canadians are affected by AF.7 In all types of AF, embolization of atrial thrombi poses a significant risk of arterial thromboembolism, transient ischemic attack, and stroke, which are associated with high recurrence and substantial debilitating impact.4,5
Edoxaban is a direct factor Xa inhibitor. Inhibition of factor Xa in the coagulation cascade leads to an anticoagulant effect. Edoxaban is administered orally, at a dosage of 60 mg once daily, and its current proposed indication is for the prevention of stroke and systemic embolism in patients with AF. Edoxaban has a Health Canada indication for the prevention of stroke and systemic embolic events (SEEs) in patients with nonvalvular atrial fibrillation (NVAF).8 We performed a systematic review of the beneficial and harmful effects of edoxaban 60 mg (30 mg dose reduced) once daily for the prevention of stroke and SEEs in patients with NVAF.
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