Abstract 154: Adherence to Rivaroxaban Compared to Other Oral Anticoagulant Agents Among Patients With Non-Valvular Atrial Fibrillation

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Colleen A McHorney ◽  
Veronica Ashton ◽  
François Laliberté ◽  
Guillaume Germain ◽  
Willy Wynant ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Patient Outcomes ◽  
Real World ◽  
Oral Anticoagulant ◽  
Index Date ◽  
Absolute Difference ◽  
Real World Data ◽  
Anticoagulant Agents ◽  
Proportion Of Days Covered ◽  
Adherence To Therapy

Background: Adherence to oral anticoagulant (OAC) agents is important for patients with non-valvular atrial fibrillation (NVAF) to prevent potentially severe adverse events. Objectives: To compare real-world adherence rates for rivaroxaban vs other oral anticoagulant agents (apixaban, dabigatran, and warfarin) among patients with NVAF using claims-based data. Methods: Healthcare claims from the IMS Health Real-World Data Adjudicated Claims database (01/2011-06/2015) were used to assess 6 month adherence rates defined as the percentage of patients with proportion of days covered (PDC) ≥0.8 and ≥0.9. Patients were included if they had ≥2 dispensings of rivaroxaban, apixaban, dabigatran, or warfarin at least 180 days apart (the first was termed as the index date), had > 60 days of supply, had ≥ 6 months of pre-index eligibility, had ≥ 1 AF diagnosis pre-index or at index date, and without valvular involvement. A logistic regression model was used to evaluate adherence to therapy adjusting for sociodemographic and clinical characteristics, insurance type, index month and year, previous OAC use, and mental-health risk factors for non-adherence (e.g., mental disorders, bipolar). Results: A total of 13,645 rivaroxaban, 6,304 apixaban, 3,360 dabigatran, and 13,366 warfarin patients were identified. A significantly higher proportion of rivaroxaban users were adherent to therapy (PDC ≥ 0.8 at 6 months vs apixaban, dabigatran, and warfarin users; Table). After adjustment, the proportion of patients adherent to therapy remained significantly higher for rivaroxaban users vs apixaban (absolute difference [AD]: 5.8%), dabigatran (AD: 9.5%), and warfarin users (AD: 13.6%; all P<0.001; Table). More pronounced differences were found with a PDC ≥0.9 (Table). Conclusion: Among NVAF patients, rivaroxaban was associated with significantly higher adherence rates relative to other OACs, whether using a PDC of ≥0.8 or ≥0.9, which could translate into improved patient outcomes and lower healthcare costs.

“Unreal world” or “real world” data in oral anticoagulant treatment of atrial fibrillation

2016 ◽  
Vol 116 (10) ◽  
pp. 587-589 ◽  
Author(s):  
Gregory Y. H. Lip ◽  
Ben Freedman
Keyword(s):  
Atrial Fibrillation ◽  
Real World ◽  
Oral Anticoagulant ◽  
Review Process ◽  
Anticoagulant Treatment ◽  
Real World Data ◽  
Oral Anticoagulant Treatment ◽  
World Data

Note: The review process for this manuscript was fully handled by Christian Weber, Editor in Chief.

scholarly journals Women with atrial fibrillation in the Middle East: utilization of oral anticoagulant agents in a population with bad baseline clinical profiles and risk scores

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Hammoudeh ◽  
R Ibdah ◽  
S Rawashdeh ◽  
A Ababneh ◽  
A Al-Kasasbeh ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Middle East ◽  
Risk Score ◽  
Oral Anticoagulant ◽  
Middle Eastern ◽  
Risk Scores ◽  
Funding Sources ◽  
Middle Eastern Women ◽  
Anticoagulant Agents ◽  
Artery Disease

Abstract Background Atrial fibrillation (AF) is the most common sustained arrhythmia in women and men worldwide and in the Middle East. Several studies have shown that women with AF are undertreated despite worse baseline clinical and risk profiles compared with men. It is largely unknown if this also applies to Middle Eastern AF patients. Purpose To evaluate baseline clinical features and utilization of guideline-recommended oral anticoagulant medications (OACs) in Middle Eastern women with AF. Methods The Jordan AF prospective multicenter study enrolled 2160 patients with AF, including 1164 (53.9%) women, in 20 hospital and outpatient clinics (May 2019 through January 2021). Results Nonvalvular AF was present in 1038 (91.0%) of women and 935 (94.6%) of men. Compared with men, women were older (mean age 69.2±11.5 years vs. 66.1±14.9 years, p&lt;0.001), and had higher prevalence of hypertension (79.1% vs. 69.5%, p&lt;0.001), diabetes (46.1% vs. 41.7%, p=0.04) and obesity (60.5% vs. 34.6%, p&lt;0.001). Women, however, had lower prevalence of two comorbidities; heart failure (21.5% vs. 28.6, p=0.001) and coronary artery disease (7.7% vs. 15.4%, p&lt;0.001) compared with men. Rate of utilization of oral anticoagulant agents (OACs) was higher in women than men with high and intermediate CHA2DS2 VASc scores (Table). Direct OACs were used in 64.0% of women and 63.3% of men with high risk score (p=NS). Multivariate analysis did not show sex to be an independent predictor of use of OACs. Conclusions Middle Eastern women with AF have worse baseline clinical and risk score profiles compared with men. In disagreement with other regional studies, the majority of these women received guideline-recommended OACs. FUNDunding Acknowledgement Type of funding sources: None.

Abstract TP519: The Effect of Different Oral Anticoagulants on Vascular Outcomes in Stroke With Atrial Fibrillation: A Real-world Data

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
Woo-Keun Seo ◽  
Joon-Tae Kim ◽  
Jong-Won Chung ◽  
Tae-Jin Song ◽  
Yong-Jae Kim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Real World ◽  
Oral Anticoagulants ◽  
Real World Data ◽  
World Data

Edoxaban versus placebo, aspirin, or aspirin plus clopidogrel for stroke prevention in atrial fibrillation

2015 ◽  
Vol 114 (08) ◽  
pp. 403-409 ◽  
Author(s):  
Lars Rasmussen ◽  
Torben Larsen ◽  
Andrew Blann ◽  
Flemming Skjøth ◽  
Gregory Lip
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Trial ◽  
Real World ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Published Data ◽  
Real World Data ◽  
Once Daily ◽  
Increased Risk ◽  
Reduced Risk

SummaryAs non-valvular atrial fibrillation (AF) brings a risk of stroke, oral anticoagulants (OAC) are recommended. In ‘real world’ clinical practice, many patients (who may be, or perceived to be, intolerant of OACs) are either untreated or are treated with anti-platelet agents. We hypothesised that edoxaban has a better net clinical benefit (NCB, balancing the reduction in stroke risk vs increased risk of haemorrhage) than no treatment or anti-platelet agents. We performed a network meta-analysis of published data from 24 studies of 203,394 AF patients to indirectly compare edoxaban with aspirin alone, aspirin plus clopidogrel, and placebo. Edoxaban 30 mg once daily significantly reduced the risk of all stroke, ischaemic stroke and mortality compared to placebo and aspirin. Compared to aspirin plus clopidogrel, there was a lower risk of intra-cranial haemorrhage (ICH). Edoxaban 60 mg once-daily had a reduced risk of any stroke and systemic embolism compared to placebo, aspirin, and aspirin plus clopidogrel. Mortality rates for both edoxaban doses were estimated to be lower compared to any anti-platelet, and significantly lower compared to placebo. With overall reduced risk of ischemic stroke and ICH, both edoxaban doses bring a NCB of mean (SD) 1.68 (0.15) saved events per 100 patients per year compared to anti-platelet drugs in a clinical trial population. The NCB was demonstrated to be lower, at 0.77 (0.12) events saved (p< 0.01) when modeled to data from a ‘real world’ cohort of AF patients. In conclusion, edoxaban is likely to provide even better protection from stroke and ICH than placebo, aspirin alone, or aspirin plus clopidogrel in both clinical trial populations and unselected community populations. Both edoxaban doses would also bring a positive NCB compared to anti-platelet drugs or placebo/non-treatment based on ‘real world’ data.Note: The review process for this paper was fully handled by Christian Weber, Editor in Chief.

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