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Off‐label underdosing of four individual NOACs in patients with nonvalvular atrial fibrillation: A systematic review and meta‐analysis of observational studies

Although several meta‐analyses have examined the effects of off‐label underdosing of nonvitamin K antagonist oral anticoagulants (NOACs) compared with their recommended doses in patients with atrial fibrillation (AF), they combined different kinds of NOACs in their primary analyses. Herein, we first conducted a meta‐analysis to separately assess the effects of off‐label underdosing versus on‐label dosing of four individual NOACs on adverse outcomes in the AF population.