The purpose of this study was to demonstrate the safety and efficacy profile, in two different dose regimens of DU-176b, (an investigational new drug being tested for the prevention of stroke/systemic embolic events (SEE)), in individuals with atrial fibrillation. Patients were randomized to one of three treatment groups: High Dose Regimen, Low Dose Regimen, & Warfarin.

MAIN RESULTS:
Edoxaban versus warfarin in patients with atrial fibrillation

N Engl J Med. 2013 Nov 28;369(22):2093-104.
PRESENTATIONS
TIMI 48 Slides
Relationship Between Edoxaban Dose, Concentration, Anti-Factor Xa Activity, and Outcomes in the ENGAGE AF-TIMI 48 Trial (Ruff, ESC 2014)
Biomarkers for the Assessment of Stroke-Systemic Embolism and Bleeding Risk in Patients with AF in ENGAGE (Berg, AHA 2018)
HF Hospitalization and Mortality in Non-Valvular AF (Inciardi, ESC 2019)
Edoxaban versus Warfarin in Atrial Fibrillation Patients with Low, Mid and High Body Weight in ENGAGE (Boriani, ESC 2019)
ENGAGE Genetics (Marston, AHA 2019)
A Targeted Proteomic Approach Identifies Novel Biomarkers of Arterial Thromboembolic Risk in ENGAGE AF-TIMI 48 (Berg, ACC 2021)
Epistaxis in Anticoagulated Patients with Atrial Fibrillation in the ENGAGE AF-TIMI 48 Trial (Semco, ESC 2021)
Effectiveness and Safety of Edoxaban in Atrial Fibrillation Patients from the ETNA-AF Global Registry (de Caterina, ESC 2021)
Evaluation of the ABC Pathway for Comprehensive Management of Atrial Fibrillation in 20,933 Patients from the ENGAGE AF-TIMI 48 Trial (Patel, AHA 2021)
A Genetic Risk Score to Predict Peripheral Artery Disease and Acute Limb Ischemia in Patients With Cardiometabolic Disease (Patel, AHA 2021)
Neutrophil-Lymphocyte Ratio and Outcomes in Patients with AF-Analyses from ENGAGE AF-TIMI 48 (Fagundes, ACC 2022)
Serial Assessment of Biomarkers and the Risk of Heart Failure in Patients (Oyama, ACC 2022) (with audio)
Safety and Efficacy of Non-Vitamin K Antagonist Oral Anticoagulants vs. Warfarin Across Body Mass Index and Body Weight – Insights from COMBINE-AF (Patel, AHA 2022)
Development of a Novel Polygenic Risk Score to Predict Risk of Aortic Stenosis Events (Small, AHA 2022)
Edoxaban 30mg vs Warfarin in 2,406 Patients Age 80 or Greater: A Randomized Analysis from ENGAGE-TIMI 48 (Zimerman, ACC 2023)
Development and Validation of the DOAC Score – A Novel Bleeding Risk Prediction Tool for Patients with Atrial Fibrillation on Direct-Acting Oral Anticoagulants (Aggarwal, ESC 2023)
Efficacy and Safety of DOACs vs. Warfarin by Background Antiplatelet Therapy in 57,598 Patients With Atrial Fibrillation (Patel, ESC 2023)
Performance of a Polygenic Risk Score for CAD Across the Spectrum of ASCVD-An Analysis of 60k Patients from 6 TIMI Randomized Trials (Zimerman, AHA 2023)
Identification Of Atrial Fibrillation Patients With Favorable Outcomes On Warfarin: An Individual Patient-Level Analysis Of 29,272 Warfarin Patients From The COMBINE-AF Study (Al Said, ACC 2024).
Should Frail Elderly AF Patients On VKA Switch To A DOAC? A Randomized Comparison From COMBINE-AF, A Patient-Level Metanalysis Of The 4 Large RCTS Of DOACs VS Warfarin (Giugliano, ACC 2024)
Frailty Status And Outcomes In 58,634 Patients With Atrial Fibrillation Randomized To DOAC VS Warfarin (Nicolau, ACC 2024)
Effect Of DOACs Versus Warfarin By ASCVD Status In 58,634 Patients With Atrial Fibrillation: A Pooled Analysis Of 4 Randomized Trials (Zimerman, ACC 2024)
Extracranial systemic embolic events in patients with atrial fibrillation-an individual patient-level meta-analysis of 71 683 patients randomized to NOAC vs warfarin (Al Said, ESC 2024)
Clinical outcomes in 10,000 Asian vs 61,000 Non-Asian race patients with AF randomized to Warfarin vs DOACs-a patient-level meta-analyses from COMBINE AF (Chao, ESC 2024)
Paul Haller – Heart failure risk assessment using biomarkers in patients with atrial fibrillation – Analysis of 32,041 patients from the COMBINE study
Evaluation of the biomarker-based ABC-AF-bleeding risk score and clinically based bleeding scores in 31,605 patients with atrial fibrillation treated with oral anticoagulation (Hijazi, ESC 2024)
Pathogenic cardiomyopathy gene variants inform prognosis in atrial fibrillation-results from exome sequencing in over 17,000 patients in TIMI trials (Jurgens, ESC 2024)
Exome sequencing in over 63,000 patients in TIMI trials uncovers pathogenic cardiomyopathy variant carriers with high risk for heart failure and cardiovascular death (Kany, ESC 2024)
Intracranial Hemorrhage in Patients with Atrial Fibrillation-Insights from COMBINE-AF (Tannu, ESC 2024)
Polygenic Risk in Heart Failure (Haller, AHA 2024)
Risk of myocardial infarction in paroxysmal vs. non-paroxysmal atrial fibrillation-an individual patient-level data analysis of 71,466 patients from COMBINE-AF Goette, AHA 2024)
Low-dose edoxaban in patients 80 years and older with atrial fibrillation and dose-reduction criteria-randomized analysis between edoxaban 15 mg and 30 mg (Zimerman, ESC 2025)
The association between sex and body size and stroke risk and survival in patients with atrial fibrillation an analysis of 71,589 patients from the COMBINE AF study (Aulin, ESC 2025)
Validation of the DOAC Score among Patients on Vitamin K Antagonists (Aggarwal, ESC 2025)
Polygenic Risk Score for Abdominal Aortic Aneurysm in Patients with Cardiometabolic Disease: Analysis of 40,000 Patients from 3 TIMI Trials (Lai, AHA 2025)
Guiding iterative decision-making in anticoagulant dosing including patient preferences of stroke vs bleeding avoidance (Gibson, CVCT 2025)
Patient-Centered Evaluation of DOACs versus Warfarin in Atrial Fibrillation (Shoji, CVCT 2025)
OTHER PUBLICATIONS
Cardioversion of Atrial Fibrillation in ENGAGE AF-TIMI 48. Clin Cardiol. 2016 Jun;39(6):345-6.
Dose Reduction of Edoxaban in Patients 80 Years and Older With Atrial Fibrillation: Post Hoc Analysis of the ENGAGE AF-TIMI 48 Randomized Clinical Trial. JAMA Cardiol. 2024 Sep 1;9(9):817-825.
