What is the clinical evidence from this study?

Study design: Cohort. Population: Atrial fibrillation (n=2932). Intervention: Dabigatran etexilate. Primary outcome: Dabigatran persistence.

What does this research mean for the field?

Approximately 70% of patients with newly diagnosed atrial fibrillation remain on dabigatran therapy after two years, with discontinuation more likely in North American patients, those with symptomatic or paroxysmal/persistent AF, and prior proton pump inhibitor users. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to describe the persistence rates of dabigatran therapy among newly diagnosed atrial fibrillation patients after two years.

June 23, 2026Open Access

Persistence With Dabigatran Therapy at 2 Years in Patients With Atrial Fibrillation

MPMiney PaquetteBoehringer Ingelheim (Canada)LFLionel Riou FrançaSanofi (France)CTChristine TeutschBoehringer Ingelheim (Germany)

Key Result

The 2-year probability of treatment persistence with dabigatran in patients with newly diagnosed atrial fibrillation was 69.2%.

Key Points

This study aims to describe the persistence rates of dabigatran therapy among newly diagnosed atrial fibrillation patients after two years.
Consecutive patients diagnosed with atrial fibrillation and at least one stroke risk factor were followed for two years.
Nonpersistence was defined as discontinuation for more than 30 days.
A multivariable Cox regression model was utilized to identify predictors of nonpersistence.
Approximately 69.2% of patients persisted with dabigatran therapy after 2 years.
7% of patients switched to a factor Xa inhibitor and 6% to a vitamin K antagonist.
Serious adverse events were reported as a reason for discontinuation in one-third of patients.

Study Design

Type

Cohort (n=2,932)

Multicenter

Yes

Structured PICO

What is the 2-year persistence rate and what are the predictors of discontinuation for dabigatran in patients with newly diagnosed atrial fibrillation?

Population

2,932 patients with newly diagnosed atrial fibrillation and ≥1 stroke risk factor, followed for 2 years.

Exposure

Dabigatran etexilate

Outcome

Dabigatran persistence over 2 years (nonpersistence defined as discontinuation of dabigatran for >30 days)

In patients with newly diagnosed atrial fibrillation, the 2-year persistence rate for dabigatran is approximately 70%, with regional variations and adverse events driving discontinuation.

Abstract

BACKGROUND: Guidelines recommend long-term oral anticoagulation therapy for stroke prevention in patients with atrial fibrillation (AF). Treatment discontinuation rates in vitamin K antagonist (VKA)-treated patients are high but may be lower with non-VKA oral anticoagulant agents. OBJECTIVES: The goal of this study was to describe and explore predictors of dabigatran etexilate persistence in patients with newly diagnosed AF over 2 years of follow-up. METHODS: Consecutive patients newly diagnosed with AF and ≥1 stroke risk factor were followed up for 2 years. Dabigatran nonpersistence was defined as discontinuation of dabigatran for >30 days. A multivariable Cox regression model included region as well as patient clinical and sociodemographic characteristics to explore predictors of nonpersistence. RESULTS: Eligible patients (N = 2,932) took ≥1 dabigatran dose; their mean age was 70.3 ± 10.2 years, and 55.3% were male. The 2-year probability of dabigatran persistence was 69.2%. Approximately 7% switched to a factor Xa inhibitor and 6% to a VKA. Approximately one-third of dabigatran discontinuations were primarily due to serious or nonserious adverse events. Patients from North America had the highest discontinuation risk, and Latin America had the lowest. Minimally symptomatic or asymptomatic AF and permanent AF were associated with a lower risk for dabigatran nonpersistence. Previous proton pump inhibitor use was associated with a higher risk for dabigatran nonpersistence. CONCLUSIONS: Probability of treatment persistence with dabigatran after 2 years was approximately 70%. Nearly one-half of the patients who stopped dabigatran switched to another oral anticoagulant agent. Patients from North America, and those with paroxysmal, persistent, or symptomatic AF, may be at a higher risk for discontinuing dabigatran.

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