Trial of Apixaban vs Warfarin in Reducing Rate of Cognitive Decline, Silent Cerebral Infarcts and Cerebral Microbleeds in Patients With Atrial Fibrillation

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

34 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-12-19

Study Completion Date

2020-12-15

Brief Summary

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The investigators' central hypothesis is that in patients with atrial fibrillation, anticoagulation with Apixaban reduces the rate of decline in cognitive function, when compared to Warfarin. The investigators also hypothesize that Apixaban reduces cognitive decline by reducing the rate of new cerebral infarction and cerebral microbleeds detected by cerebral MRI compared to warfarin.

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Detailed Description

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Conditions

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Atrial Fibrillation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Eliquis

Group Type ACTIVE_COMPARATOR

Apixaban

Intervention Type DRUG

Dosage either 5mg or 2.5mg for 2 years

Warfarin

Group Type ACTIVE_COMPARATOR

Warfarin

Intervention Type DRUG

Dosage assessed by your treating physician for 2 years

Interventions

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Apixaban

Dosage either 5mg or 2.5mg for 2 years

Intervention Type DRUG

Warfarin

Dosage assessed by your treating physician for 2 years

Intervention Type DRUG

Other Intervention Names

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Eliquis Coumadin

Eligibility Criteria

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Inclusion Criteria

* Non-valvular Atrial Fibrillation
* CHA2DS2-VASc Score \> or = to 2
* Never been treated with Apixaban (Eliquis) or prior treatment of \< 1 month
* Candidate for oral anticoagulation as assessed by a treating physician

Exclusion Criteria

* Valvular Atrial Fibrillation (Rheumatic valve disease,Moderate or greater mitral stenosis,Mechanical cardiac valve)
* Active Bleeding
* Prior treatment with Apixaban \>1 month
* Recent stroke within 7 days
* Dementia
* Implanted devices not compatible with MRI/any cardiac implanted device
* Claustrophobia
* Active alcohol/drug abuse
* Life expectancy \< 1 year
* Taking asprin with \>100mg doses
* Known hypersensitivity to warfarin or Apixaban
* Severe renal insufficiency
* Prior severe bleeding (Intracranial bleeding (subdural, subarachnoid, intraparenchymal bleeding),GI bleed requiring transfusion,Bleeding from other sites requiring transfusion)
* Psychosocial reasons that make study participation impractical
* Currently enrolled in another IND or IDE trial that has not completed the primary endpoint or that clinically interferes with the current study endpoints
* Co-morbid condition(s) that could limit the subject's ability to participate in the trial or to comply with follow-up requirements, or that could impact the scientific integrity of the study.
* Prisoners or subjects who are involuntarily incarcerated
* Subjects who are compulsorily detained for treatment of either psychiatric or physical illness
* Current or expected systemic treatment with strong dual inhibitors of CYP3A4 and P-gp (Any one of rifampin, carbamazepine, phenytoin, St. John's Wort, ketoconazole, itraconazole, ritonavir, clarithromycin)
* Need for dual anti-platelet therapy with aspirin and another agent such as thienopyridine

Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No