What does this research mean for the field?

Among patients with non-valvular atrial fibrillation, treatment with rivaroxaban is associated with significantly higher medication persistence and lower discontinuation rates compared to warfarin. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

June 13, 2014Current Medical Research and Opinion

Medication persistence and discontinuation of rivaroxaban versus warfarin among patients with non-valvular atrial fibrillation

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Why the study?

Does rivaroxaban improve medication persistence and reduce discontinuation compared to warfarin in patients with non-valvular atrial fibrillation?

Structured PICO

Does rivaroxaban improve medication persistence and reduce discontinuation compared to warfarin in patients with non-valvular atrial fibrillation?

Population

14,518 patients (7,259 matched pairs) with non-valvular atrial fibrillation (NVAF) from a large nationally representative US claims database.

Intervention

Rivaroxaban

Comparator

Warfarin (matched 1:1 by propensity scores)

Outcome

Medication persistence (absence of refill gap of ≥ 60 days) and discontinuation (no additional refill for at least 90 days and until the end of follow-up)

Rivaroxaban demonstrates superior real-world medication persistence and lower discontinuation rates compared to warfarin in patients with non-valvular atrial fibrillation.

Limitations

Claims data may have contained inaccuracies and miscoding
Confounding may remain even after propensity score matching and additional adjustments in model
Refill data may not fully reflect actual medication use
Longer follow-up may produce more precise estimates of persistence and discontinuation

Discussion

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Implication

May favor rivaroxaban for persistence in NVAF; leaves open randomized confirmation of outcome benefits.

Cite This Study

Nelson et al. (2014) studied this question.

synapsesocial.com/papers/6a1d49feba3016ff712f6250 https://doi.org/10.1185/03007995.2014.933577

Topics

Atrial fibrillation Persistent AF management Anticoagulation in AF

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Medication persistence and discontinuation of rivaroxaban versus warfarin among patients with non-valvular atrial fibrillation

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Medication persistence and discontinuation of rivaroxaban versus warfarin among patients with non-valvular atrial fibrillation

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider