The Medical Letter on warfarin versus TSOACs for atrial fibrillation

This Medical Letter summary was published in JAMA. The Medical Letter tends to be conservative when it comes to newer drugs. They were true to form on this issue. From the summary:

Patients with nonvalvular atrial fibrillation who are taking warfarin and whose INR generally remains within the therapeutic range should probably stay on it. New patients and those who are difficult to maintain in the therapeutic range of INR might benefit from treatment with dabigatran (Pradaxa), rivaroxaban (Xarelto), or apixaban (Eliquis). Of the three, apixaban was the only one shown to cause less overall bleeding than warfarin, but direct comparisons between the new drugs and long-term data on outcomes are lacking.

The summary outlines the advantages and disadvantages of TSOACs versus warfarin.