Comparing the Safety and Efficacy of Apixaban and Rivaroxaban (NCT06953726) | Clinical Trial Compass
Not Yet RecruitingPhase 4
Comparing the Safety and Efficacy of Apixaban and Rivaroxaban
United States10,000 participantsStarted 2026-06-01
Plain-language summary
* The trial will compare two anticoagulants ("blood thinners") that are currently used in the VA and are considered standard care to prevent strokes in patients with atrial fibrillation. The two most commonly-used anticoagulants will be compared: apixaban (Eliquis) and rivaroxaban (Xarelto). They are considered by many doctors to have similar benefits and risks, but no one knows for sure.
* The trial only enrolls patients with a diagnosis of atrial fibrillation ("A Fib") or atrial flutter. Most participants will be age 65 or older, and should already be taking apixaban or rivaroxaban.
* The investigators will measure, in about 10,000 VA patients nationally, whether the rates of stroke, major bleeding, or death differ between these two drugs.
* The trial will last about 7 years, but after the first prescription, all information will be collected from electronic medical records.
Who can participate
Age range65 Years
SexALL
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Inclusion criteria
✓. Male or female Veteran, aged 22 years or older
✓. Diagnosis of atrial fibrillation (AF) or atrial flutter (AFL) and currently taking either apixaban or rivaroxaban.
✓. CHA2DS2-Vasc of 3 or more
✓. Ability to take oral medication and self-reported willingness to adhere to the prespecified apixaban or rivaroxaban regimen
Exclusion criteria
✕. Current use of oral or injectable anticoagulation, without ability to switch to the assigned study medication
✕. Another indication for anticoagulation, such as pulmonary embolism
✕. Contraindication to oral anticoagulation
✕. Known bleeding diathesis
✕. Documented current pregnancy or lactation in the EHR or self-reported current pregnancy or lactation
✕. Known allergic reactions or intolerance to apixaban or rivaroxaban
✕. Most recent estimated glomerular filtration rate (eGFR) is \< 30 mL/minute/1.73m2. An eGFR result must have been obtained within 18 months before randomization.