NOACs (novel oral anticoagulants) or DOACs (direct oral anticoagulants) are considered safe alternatives to VKAs ( vitamin k antagonists) like warfarin.
However, in a recent trial conducted in Frail Elderly Individuals with atrial fibrillation, switching from VKAs to NOACs resulted in a 69% increased risk of bleeding in the NOACs group (Frail-AF Trial).
Because NOACs are relatively new drugs and data regarding its safety in elderly patients with multiple comorbid conditions, polypharmacy, and bleeding risks is not sufficient.