The direct factor Xa inhibitor apixaban (Eliquis(®)) has predictable 
pharmacodynamics and pharmacokinetics and does not require routine 
anticoagulation monitoring. This article reviews the efficacy and tolerability 
of oral apixaban to reduce the risk of stroke or systemic embolism in patients 
with nonvalvular atrial fibrillation (AF). In the ARISTOTLE (Apixaban for 
Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) 
trial in patients with AF and at least one additional risk factor for stroke, 
apixaban recipients were significantly less likely than warfarin recipients to 
experience stroke or systemic embolism, major bleeding or death; the beneficial 
effects of treatment with apixaban versus warfarin were generally maintained 
across various patient subgroups. Apixaban recipients also had a significantly 
lower risk of intracranial haemorrhage than warfarin recipients. In the AVERROES 
(Apixaban Versus Acetylsalicylic Acid to Prevent Stroke in Atrial Fibrillation 
Patients who have Failed or are Unsuitable for Vitamin K Antagonist Therapy) 
trial in patients with AF and at least one additional risk factor for stroke for 
whom vitamin K antagonist therapy was unsuitable, apixaban was associated with a 
significantly lower risk of stroke or systemic embolism than aspirin, without an 
increase in the risk of major bleeding. In conclusion, although longer-term 
efficacy and safety data are needed, apixaban is an important new option for use 
in patients with nonvalvular AF to reduce the risk of stroke or systemic 
embolism.