This might be of interest to those a bit cautious of trialling NOAC's. The full link is here bmj.com/content/359/bmj.j4323 but I'm nt sure if you're able to open it. (some of the other links I've posted don't always work without a sign in).
New anticoagulants are not associated with an increased risk of major bleeding
According to a study published in the BMJ, treatment with direct oral anticoagulants (DOACs), compared to warfarin, is not associated with an increased risk of major bleeding or all-cause mortality.
For the study, researchers examined data from 59,525 adults with a new diagnosis of venous thromboembolism and prescription for a DOAC or warfarin within 30 days after diagnosis. Participants were followed up for 85 days on average. Hospital admissions or emergency room visits due to major hemorrhage and all-cause deaths were recorded up to 90 days after starting treatment.
The authors observed that the risk of major bleeding was similar for DOACs when compared to warfarin. No difference in risk of death was observed between the two treatment groups. The results remained unchanged after further analysis, including when a longer follow-up period (180 days) was used. The results were consistent for patients with and without chronic kidney disease in all age groups and for both men and women.
The authors said further studies are needed to understand the safety of DOACs in the long term and in patients with advanced chronic kidney disease.