Orális antikoagulánssal már kezelt pitvarfibrilláló betegek egyéves terápiahűsége

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Atrial fibrillation (n=196016). Intervention: Direct oral anticoagulants (DOACs) vs. Vitamin K antagonists (VKAs). Primary outcome: One-year persistence rate (p=<0.001).

Gábor Simonyi; Tamás Ferenci; Ervin Finta; Roland Gasparics; Mihály Medvegy

doi:10.1556/650.2019.31347

March 1, 2019Orvosi HetilapOpen Access

Orális antikoagulánssal már kezelt pitvarfibrilláló betegek egyéves terápiahűsége

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Why the study?

In the treatment of non-valvular AF with oral anticoagulants, adherence is relevant for stroke prevention, motivating evaluation of one-year persistence with VKAs and DOACs in pre-treated patients.

Does DOAC therapy improve one-year persistence compared to VKA therapy in patients with atrial fibrillation already treated with oral anticoagulants?

Study Design

Type

Cohort (n=196,016)

Structured PICO

Does DOAC therapy improve one-year persistence compared to VKA therapy in patients with atrial fibrillation already treated with oral anticoagulants?

P

Population

196,016 patients with atrial fibrillation already treated with oral anticoagulants were followed for one year to evaluate medication persistence.

E

Exposure

Direct oral anticoagulants (DOACs: rivaroxaban, apixaban, dabigatran)

C

Comparator

Vitamin K antagonists (VKAs)

O

Outcome

One-year persistence rate (time to abandon medication)

Main Result

Absolute Event Rate: 66.8% vs 52.9%

p-value: p=<0.001

Limitations

Retrospective design using a pharmacy claims database cannot assess primary non-adherence.
Persistence data could not be stratified by the exact time of the first prescription fill.
Lack of data on potential confounders such as sex, age, social status, and disease severity.
Edoxaban was excluded from the analysis as it became available after the study period.
Retrospective analysis of prescription claims database
Inability to assess primary non-adherence
Lack of data on potential confounders such as age, sex, social status, and disease severity
Edoxaban was not included as it was not available during the study period

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Implication

In patients with atrial fibrillation already treated with oral anticoagulants, one-year persistence was significantly higher for DOACs compared to VKAs, with rivaroxaban showing the highest persistence among DOACs.

Abstract

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Discussion

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Cite This Study

Simonyi et al. (2019) conducted a cohort in Atrial fibrillation (n=196,016). Direct oral anticoagulants (DOACs) vs. Vitamin K antagonists (VKAs) was evaluated on One-year persistence rate (p=<0.001).

synapsesocial.com/papers/6a222c8a90e08a953958259b https://doi.org/10.1556/650.2019.31347

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Orális antikoagulánssal már kezelt pitvarfibrilláló betegek egyéves terápiahűsége

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Orális antikoagulánssal már kezelt pitvarfibrilláló betegek egyéves terápiahűsége

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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