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The comparative risk for gastrointestinal bleeding (GIB) with non-vitamin K antagonist oral anticoagulants (NOACs) was compared to vitamin K antagonists or anti-platelet agents in a recent metanalysis, which showed no significant difference in major GIB events between these agents.
A systematic review focused on 43 randomized controlled trials, 183,752 patients and 41 real-world studies (1,879,428 patients). NOACs include popular drugs such as dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis).
The pooled major rates of GIB were:
- NOACs 1.19%
- Conventional treatment 0.92%
Comparative results were not significant in randomized controlled trials or from real-world studies.
Rivaroxaban, but not other NOACs, was associated with an increased risk for major GIB (RR 1.39; 95% CI, 1.17-1.65 and RR 1.14; 95% CI, 1.04-1.23).