Eliquis Lowers Stroke Risk, But Side Effects Linked to Higher Risk of Major Bleeding: Study

The findings of a new study suggests that the blood thinner Eliquis (apixaban) may be better than aspirin at preventing blood clots and strokes, but side effects are more likely to cause serious bleeding problems among patients.

A team of international medical researchers report that Eliquis lowers the risk of stroke and blood clots among patients with irregular heart rhythms. However, nearly one out of every 50 patients who took the drug developed major bleeding events, according to findings published on January 11 in the New England Journal of Medicine.

Eliquis was introduced in 2012 as part of a new class of blood thinner medications to reduce the risk of blood clots and strokes, particularly among patients with atrial fibrillation. It was marketed as a replacement for warfarin, which has been the most commonly used blood thinner for decades. However, Eliquis was associated with severe and uncontrollable bleeding events, and lacked a reversal agent that could quickly counteract the blood thinning effects when it was first released, which led to a number of serious injuries.

Atrial fibrillation (AF) is a heart rhythm disorder, and is defined as subclinical when irregular heartbeats are only detected on an implanted pacemaker or defibrillator device.

Researchers in the latest study indicate individuals who suffer from the subclinical version of the disorder face an increased risk of stroke, and warn the benefits Eliquis provides remains uncertain.

Eliquis Linked to Major Bleeding Event Risks

In the study, a team of medical researchers from several different countries conducted a randomized trial to see how effective Eliquis was in preventing strokes, using the data on 4,012 patients who had subclinical AF episodes lasting from six minutes to 24 hours. Participants were randomly assigned into two groups; one was prescribed 5 mg of Eliquis daily, while the other took 81 mg of aspirin daily. The medications were stopped if episodes continued for more than 24 hours, or if AF symptoms were detected without an implanted cardiac device.

According to the data, 86 participants among the aspirin group suffered from a stroke or blood clot, compared to only 55 participants among the Eliquis group. The data also revealed the rate of major bleeding events reported among patients in the Eliquis group was 1.71% per year, compared to 0.94% among those in the aspirin group.

“Among patients with subclinical atrial fibrillation, apixaban resulted in a lower risk of stroke or systemic embolism than aspirin but a higher risk of major bleeding,” the researchers concluded.

The findings are similar to those revealed in prior research, which has linked Eliquis, Xarelto, Pradaxa and similar blood thinning medications to increased bleeding risks.

It was not until a reversal agent, Andexxa, was approved for Eliquis and Xarelto in 2018, that doctors were provided a means to quickly combat the drugs’ bleeding risks.