Scientists find best blood thinner for minimizing bleeding risk

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A large-scale study led by UCL researchers shows apixaban as the safest option among direct oral anticoagulants (DOACs).

The drug is associated with the lowest risk of gastrointestinal bleeding. The findings are particularly relevant for patients over 80 and those with chronic kidney disease, groups often underrepresented in clinical trials.

Safest Option Among Blood Thinners

In a study published in the Annals of Internal Medicine, UCL researchers have identified apixaban as the direct oral anticoagulant associated with the lowest risk of gastrointestinal bleeding.

The drug is commonly prescribed for atrial fibrillation, a condition affecting more than 33 million people worldwide.

Comparative Efficacy

The researchers reviewed data from more than 500,000 new DOAC users in the UK, France, Germany, and the US.

While all four of the most common DOACs—apixaban, dabigatran, edoxaban, and rivaroxaban—performed similarly in preventing ischemic strokes, brain bleeds, and all-cause mortality, apixaban was associated with 19-28% lower risks of gastrointestinal bleeding compared to the other three DOACs.

A Comprehensive Analysis

This large-scale study has the distinction of including data from patient groups that are often underrepresented in clinical trials, such as those over the age of 80 and those with chronic kidney disease.

“Our results indicate that apixaban may be preferable to other blood thinners because of the lower rate of gastrointestinal bleeding,” said co-lead author Dr. Wallis Lau from the UCL School of Pharmacy.

Individual Considerations

Although apixaban has been identified as the safest option among DOACs in terms of gastrointestinal bleeding, Dr. Lau stresses that medication suitability may vary from person to person.

“As with all medications, potential risks and benefits can differ between people, so considering the full spectrum of outcomes and side effects will still be necessary for each individual patient,” he explained.


The UCL study adds to the growing body of evidence suggesting apixaban may be the safest and most effective choice for blood thinning, especially in terms of minimizing gastrointestinal bleeding risk.

These findings could have a significant impact on the medical community’s approach to prescribing anticoagulants.

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The research findings can be found in the Annals of Internal Medicine.

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