Low-Dose Edoxaban in Older Adult Patients With Atrial Fibrillation

The ELDERCARE-AF clinical trial evaluated the effect of edoxaban in adults aged 80 years or older with atrial fibrillation (AF) who were not considered eligible for standard oral anticoagulant therapy to prevent stroke, reports the New England Journal of Medicine . Conducted in Japan, the Phase III study included patients with nonvalvular AF. One-half of the participants — 492 — were randomized to edoxaban 15 mg once daily, with the remainder allocated to placebo. The main efficacy outcome was a composite of stroke or systemic embolism, which occurred at an annualized rate of 2.3 percent in the intervention group and 6.7 percent in the control group. Major bleeding—the primary safety endpoint—occurred at an annualized rate of 3.3 percent and 1.8 percent, respectively. The results suggest that once-daily edoxaban was superior to placebo in preventing stroke or systemic embolism in adults aged 80 years and older with nonvalvular AF and did not generate a significantly higher rate of major bleeding than placebo.