OI 10.2450/2017.0196-SIMTI Servizi SrlTIBackground. Direct oral anticoagulants (DOAC) have already been shown to be non-inferior to classic vitamin K antagonists in preventing stroke and arterial thromboembolism in patients with non-valvular atrial fibrillation. Nonetheless, it is mandatory to record unwanted effects and person adherence to DOAC treatment. Supplies and procedures. In this single-centre expertise, sufferers with non-valvular atrial fibrillation had been prospectively observed just after switching from a vitamin K antagonist to dabigatran or rivaroxaban. The efficacy, safety, and tolerability of the novel remedy, and adherence to it, were evaluated more than a period of 1 year. Clinical information had been integrated with records of haemorrhagic and non-haemorrhagic complications. Each of the subjects were provided an anonymous self-report questionnaire on the degree of their adherence/satisfaction using the treatment. Final results. Of 196 individuals with non-valvular atrial fibrillation (median age, 78.five years) who switched from a vitamin K antagonist to DOAC, 178 completed the 1-year stick to up, of whom 87 have been given dabigatran and 91 rivaroxaban. The efficacy in the two DOAC was comparable. Sufferers offered dabigatran had a greater frequency (n=32) of non-haemorrhagic complications (OR: 3.3; 95 CI: 1.7-7.8), which occurred earlier (HR: six.1; 95 CI: three.0-12.6) than these (n=7) recorded in subjects on rivaroxaban. The degree of satisfaction with therapy was larger among sufferers on rivaroxaban (mean score 9.1, SD 1.0) than among those on dabigatran (mean score 8.7; SD 0.9; p=0.01). Discussion. Overall, within this expertise, DOAC had been shown to become successful, safe alternatives to vitamin K antagonists. Nevertheless, compared with rivaroxaban, dabigatran resulted in a higher price and earlier occurrence of non-haemorrhagic events, along with a decrease satisfaction score.IL-13, Mouse Se rv icompared to VKA, and be associated having a reduce incidence of main bleeding, particularly intracranial haemorrhage, as demonstrated in well-known controlled clinical trials4-7.IL-2 Protein Biological Activity The capacity to inactivate bound serine proteases tends to make DOAC stronger than warfarin and heparins. Furthermore, compared to warfarin, DOAC possess a favourable risk-benefit balance for stopping stroke and systemic arterial thromboembolism. Caution is recommended with prescribing dabigatran to elderly individuals simply because this DOAC, at a dose of 150 mg twice everyday, has been related with a larger risk of main bleeding. Coagulation monitoring isn’t required, but individuals needs to be followed up periodically using the aim of detecting new wellness states that could transform the anticipated effectiveness or safety on the drugs8. The Italian Medicines Agency (Agenzia Italiana del Farmaco – AIFA) has so far licensed three DOAC, which have been commercially accessible because 20132014: dabigatran etexilate (Pradaxa [Boehringer Ingelheim,Rhein, Germany] 150/110 mg bid),ziSr lAll rights reserved – For individual use only No other use without premissionSchiavoni M et alrivaroxaban (Xarelto [Bayer Pharma AG, Berlin, Germany] 20/15 mg od) and apixaban (Eliquis [Bristol-Myers Squibb, New York, USA] 5/2.PMID:25027343 5 mg bid). Prescription of those drugs was permitted only by some specialists, particularly cardiologists, internists, neurologists, geriatricians and haematologists. To establish eligibility for prescription of DOAC, the AIFA needs answers (yes/no) to a questionnaire collecting some private info and data on a prospective patient’s overall health status so as to evalu.