In a 68-year-old man with non-valvular atrial fibrillation and a preference for once-daily dosing, which medication is most appropriate for stroke prevention?

In a 68-year-old man with non-valvular atrial fibrillation and a preference for once-daily dosing, which medication is most appropriate for stroke prevention?

• A. Apixaban
• B. Edoxaban
• C. Dabigatran
• D. Rivaroxaban

Answer: (B)

When choosing a strategy to prevent stroke in nonvalvular atrial fibrillation, you want strong protection with good safety and a regimen that supports the patient’s adherence. For once-daily DOACs, two options exist, but one stands out for an older patient: it provides comparable stroke prevention to warfarin with a favorable bleeding profile, and its dosing is simple and truly once daily without additional meal-related absorption considerations. This makes it easier to maintain adherence and minimizes the risk of serious bleeding, including intracranial hemorrhage, which is particularly important in later life. Dosing can be adjusted based on renal function, which is a common consideration in an older adult. Taken together, this profile makes edoxaban the most appropriate choice for someone who prioritizes once-daily dosing and a strong safety record.

When choosing a strategy to prevent stroke in nonvalvular atrial fibrillation, you want strong protection with good safety and a regimen that supports the patient’s adherence. For once-daily DOACs, two options exist, but one stands out for an older patient: it provides comparable stroke prevention to warfarin with a favorable bleeding profile, and its dosing is simple and truly once daily without additional meal-related absorption considerations. This makes it easier to maintain adherence and minimizes the risk of serious bleeding, including intracranial hemorrhage, which is particularly important in later life. Dosing can be adjusted based on renal function, which is a common consideration in an older adult. Taken together, this profile makes edoxaban the most appropriate choice for someone who prioritizes once-daily dosing and a strong safety record.